Skip Ribbon Commands
Skip to main content
Sign In

22587 Extractable Nuclear Antibodies

Extractable Nuclear Antibodies
Test Code: ENA
Synonyms/Keywords
Extractable Nuclear Antigen, ENA, ANA Confirmatory​, ANA-subset
Test Components
Ribosomal-P, SSA, SSB, Sm, SmRNP, Ribonucleoprotein (RNP), Scl-70, JO1
Useful For
Antinuclear antibodies occur in connective tissue diseases including systemic lupus erythematosus (SLE), mixed connective tissue disease (MCTD), Sjogren's syndrome, and scleroderma. The ENA is recommended after a positive ANA IFA screen to identify the most common specific antibodies occurring in many of the connective tissue disorders. This method eliminates the false positive ANA IFA results due to naturally occurring autoantibodies that appear with most immunofluorescent detection.​
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Serum​ Red Top Tube (RTT) or Serum Separator Tube (SST) ​ 1.0 mL​ 0.5 mL​ 0.5 mL​
Specimen Stability Information
Specimen Type Temperature Time
Serum​ ​ Refrigerate​ 7 days​
Frozen > 7 days​
Rejection Criteria
Gross lipemia
Gross hemolysis​
Heat inactivated samples​
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 1 day​ Multiplex Flow Immunoassay/Bio-Rad BioPlex 2200​
Test Information

Extractable Nuclear Antibodies (ENA) assay detects the presence of autoantibodies in the blood that react with proteins in the cell nucleus. It is used to confirm the presence of specific antibodies as follow-up after a positive ANA IFA test (specifically with speckled pattern). The ENAs are known as "extractable" because they can be removed from the cell nuclei using saline and represent six main proteins: SSA/Ro, SSB/La, Sm, RNP, Scl-70, and Jo-1.

Reference Range Information
Performing Location Reference Range
Marshfield​
Negative
 dsDNA (0.0-0.4)
Chromatin: Negative (<1.0)
Ribo P: Negative (<1.0)
SSA: Negative (<1.0)
SSB: Negative (<1.0)
Cent B: Negative (<1.0)
Sm: Negative (<1.0)
SmRNP: Negative (<1.0)
RNP: Negative (<1.0)
Scl 70: Negative (<1.0)
Jo1: Negative (<1.0) ​
Interpretation

​SSA/SSB: Positive result supports the diagnosis of Sjogren's syndrome or other connective tissue diseases.

Sm: Positive result supports diagnosis of SLE with renal involvement

RNP: Positive result supports diagnosis of mixed connective tissue disease, which resembles SLE but is not accompanied by renal involvement.

Scl-70: Positive result supports diagnosis of scleroderma

Jo-1: Positive result supports diagnosis of polymyositis

Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
86038​ ​1 ANA Screen​
86235 ​ ​6 ENA (if needed)​
Synonyms/Keywords
Extractable Nuclear Antigen, ENA, ANA Confirmatory​, ANA-subset
Test Components
Ribosomal-P, SSA, SSB, Sm, SmRNP, Ribonucleoprotein (RNP), Scl-70, JO1
Ordering Applications
Ordering Application Description
​Centricity ​Extractable Nuclear Antibodies
​Cerner ​Extractable Nuclear Antibodies
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Serum​ Red Top Tube (RTT) or Serum Separator Tube (SST) ​ 1.0 mL​ 0.5 mL​ 0.5 mL​
Specimen Stability Information
Specimen Type Temperature Time
Serum​ ​ Refrigerate​ 7 days​
Frozen > 7 days​
Rejection Criteria
Gross lipemia
Gross hemolysis​
Heat inactivated samples​
Useful For
Antinuclear antibodies occur in connective tissue diseases including systemic lupus erythematosus (SLE), mixed connective tissue disease (MCTD), Sjogren's syndrome, and scleroderma. The ENA is recommended after a positive ANA IFA screen to identify the most common specific antibodies occurring in many of the connective tissue disorders. This method eliminates the false positive ANA IFA results due to naturally occurring autoantibodies that appear with most immunofluorescent detection.​
Test Components
Ribosomal-P, SSA, SSB, Sm, SmRNP, Ribonucleoprotein (RNP), Scl-70, JO1
Reference Range Information
Performing Location Reference Range
Marshfield​
Negative
 dsDNA (0.0-0.4)
Chromatin: Negative (<1.0)
Ribo P: Negative (<1.0)
SSA: Negative (<1.0)
SSB: Negative (<1.0)
Cent B: Negative (<1.0)
Sm: Negative (<1.0)
SmRNP: Negative (<1.0)
RNP: Negative (<1.0)
Scl 70: Negative (<1.0)
Jo1: Negative (<1.0) ​
Interpretation

​SSA/SSB: Positive result supports the diagnosis of Sjogren's syndrome or other connective tissue diseases.

Sm: Positive result supports diagnosis of SLE with renal involvement

RNP: Positive result supports diagnosis of mixed connective tissue disease, which resembles SLE but is not accompanied by renal involvement.

Scl-70: Positive result supports diagnosis of scleroderma

Jo-1: Positive result supports diagnosis of polymyositis

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 1 day​ Multiplex Flow Immunoassay/Bio-Rad BioPlex 2200​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
86038​ ​1 ANA Screen​
86235 ​ ​6 ENA (if needed)​
For most current information refer to the Marshfield Laboratory online reference manual.