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AAP Grand Rounds 2:38-39 (1999) ANA Titers: What Is Normal?Source: Craig WY, Ledue TB, Johnson AM, Ritchie RF. The distribution of antinuclear antibody titers in "normal" children and adults. J Rheum. 1999;26(4):914919.
Many children are referred to pediatric rheumatologists because laboratory testing revealed a "positive ANA." These referrals are based on data obtained in the 197080s which concluded that children who have positive antinuclear antibodies (ANAs) usually develop identifiable autoimmune diseases.1 These conclusions were valid for ANA titers performed by the traditional "tissue ANA" method which used rat kidney as substrate. For the past decade, however, the substrate used to test for ANA has been Hep II cells, a human cell line. The use of Hep II cells has made it possible to detect a wide spectrum of antibodies (anti-centromere, anti-nucleolar, etc) but the test has a higher false positive rate than the tissue ANA. Tan et al
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