Test Quick Guide

The anti-double stranded DNA (anti-dsDNA) tests are used to help diagnose and monitor lupus, also called systemic lupus erythematosus or SLE, a chronic inflammatory autoimmune disorder in which the immune system mistakenly targets the body’s own cells and tissues.

Your doctor may order an anti-dsDNA if you have a positive antinuclear antibody (ANA) test and symptoms associated with lupus, such as persistent fatigue, pain in your joints, and a red rash resembling a butterfly across the nose and cheeks. Anti-dsDNA tests are also periodically used to assess disease activity in people who have already been diagnosed with lupus.

About the Test

Purpose of the test

The anti-dsDNA test helps diagnose lupus if you have a positive result on a test for ANA and have clinical signs and symptoms that suggest lupus.

Typically, an ANA test is the first test performed to evaluate if you have an autoimmune disorder. While a positive ANA test is seen in about 95% of lupus cases, it may be seen in many other conditions as well. The anti-dsDNA test is fairly specific for lupus but only 65-85% of people with lupus may be positive so a negative anti-dsDNA does not rule out lupus.

If you have a positive ANA, an anti-dsDNA test may be used to distinguish lupus from other autoimmune disorders that have similar signs and symptoms.

To help establish a diagnosis, an anti-dsDNA test may be ordered along with a test for anti-Sm (Smith antibody), another ANA associated with lupus. The anti-Sm test may be ordered as part of an extractable nuclear antigen antibodies (ENA) panel.

Depending upon clinical signs and the health care practitioner’s suspicions, other autoantibodies may also be ordered to help distinguish between, and rule out, other autoimmune disorders. Examples include tests for histone antibody (drug-induced lupus) and antiphospholipid antibodies.

The anti-dsDNA test may be used to assess disease activity if you have been diagnosed with lupus. Those with lupus often have flare-ups in which symptoms worsen and then subside. An increased anti-dsDNA level may be seen prior to and during these flare-ups.

In particular, this test may be used to monitor lupus nephritis, a serious complication of lupus that can cause kidney damage and inflammation. This can lead to protein in the urine, high blood pressure, and kidney failure. It occurs when the autoantibodies bind to antigens that have been deposited in the kidneys.

What does the test measure?

Anti-dsDNA specifically targets the genetic material (DNA) found in the nucleus of a cell, identifying the presence of these autoantibodies in the blood.

Anti-dsDNA is one of a group of autoantibodies called ANA. Normally, antibodies protect against infection, but autoantibodies are produced when your immune system fails to adequately distinguish between “self” and “non-self.” They mistakenly attack your body’s own healthy cells, causing tissue and organ damage.

While anti-dsDNA may be present at a low level with a number of disorders, it is primarily associated with lupus. A chronic inflammatory autoimmune disorder, lupus can affect various tissues and/or organs of the body such as the kidneys, joints, blood vessels, skin, heart, lungs, and the brain.

The test for anti-dsDNA, along with other autoantibody tests, may be used to help establish a diagnosis of lupus and distinguish it from other autoimmune disorders.

One serious complication of lupus is lupus nephritis, a condition marked by inflammation of the kidneys, which can lead to protein in the urine, high blood pressure, and kidney failure. It occurs when autoantibodies bind to antigens that have been deposited in the kidneys.

In the evaluation of someone with lupus nephritis, a high level (titer) of anti-dsDNA is generally associated with ongoing inflammation and damage to the kidneys.

When should I get this test?

An anti-dsDNA test is ordered if you’re showing signs and symptoms that could be due to lupus and have had a positive ANA test, especially when the ANA test result presents as a “homogeneous” or “speckled” fluorescent pattern.

Examples of some signs and symptoms of lupus include:

  • Muscle pain
  • Arthritis-like pain in one or more joints (but no or little joint damage)
  • Red rash that frequently resembles a butterfly across the nose and cheek areas (malar rash)
  • Low-grade fever
  • Persistent fatigue, weakness
  • Skin sensitivity to light
  • Hair and weight loss
  • Numbness or tingling in the hands or feet
  • Inflammation and damage to organs and tissues, including the kidneys, lungs, heart, lining of the heart, central nervous system, and blood vessels

The anti-dsDNA test may be ordered periodically to monitor progress of the disease or flare-ups if you’ve been diagnosed with lupus. It may be repeated when an initial test result is negative but clinical signs and symptoms persist and lupus is strongly suspected.

Finding an Anti-dsDNA Test

How can I get an anti-dsDNA test?

Normally your doctor orders an anti-dsDNA test if you show signs and symptoms of lupus and have had a positive ANA test. Since anti-dsDNA tests require specialized equipment, your blood will be drawn in a laboratory that performs this type of test. You can also order online with testing by a Clinical Laboratory Improvement Amendments (CLIA) approved lab.

Can I take the test at home?

Normally the anti-dsDNA test is not done at home because it requires specialized equipment, but you can order a test for yourself online from certified laboratories.

How much does the test cost?

The cost of an anti-dsDNA test varies based on many factors and depends on whether you have insurance coverage and where the blood sample is taken and analyzed.

Your health insurance may cover the test when ordered by a doctor. Since health plans vary, be sure to discuss the cost of the test, including any copays or deductibles you may owe, with your health plan.

If you don’t have health insurance, you may also need to pay for the cost of the office visit and sample collection, plus any technician fees. Testing is also available without a doctor’s order at some laboratories, but costs will vary based on location.

Taking an Anti-dsDNA Test

Anti-dsDNA tests are done using a blood sample drawn from the vein in your arm.

Before the test

Generally, there are no preparatory requirements before getting an anti-dsDNA test. As with other blood tests, talk to your doctor about any prescription or over-the-counter drugs you are taking. Some labs recommend that if you are taking Biotin (also known as vitamin B7, B8, H, or coenzyme R), you stop taking it at least 72 hours before giving your sample.

During the test

Anti-dsDNA tests may be performed using different assays. Many laboratories use an anti-dsDNA ELISA test (enzyme-linked immunosorbent assay), but other methods may also be used.

During the test, a medical professional will insert a needle into a vein in your arm to collect a blood sample. The blood is collected in an attached vial, and usually takes less than five minutes to complete.

Anti-dsDNA is sometimes present with diseases such as chronic hepatitis, primary biliary cirrhosis, and infectious mononucleosis. It may also be seen in those taking drugs such as procainamide and hydralazine, though it is not usually tested or monitored under these conditions.

In addition to testing for anti-dsDNA, there is also an anti-single-stranded DNA (anti-ssDNA) test. This autoantibody is less commonly tested and is not strongly associated with lupus but may be seen with other autoimmune disorders.

ANA consists of a group of antinuclear antibodies. If an ANA test is negative, it indicates that the entire group is negative. Since anti-dsDNA is a member of this group, it does not need to be ordered separately when an ANA test is negative.

After the test

After a blood sample is collected, a bandage or piece of gauze may be applied to reduce additional bleeding. Risks of blood collection are minimal, although you may have light bruising and tenderness where the needle was inserted. There are no restrictions on normal activities after a blood sample is collected.

Anti-dsDNA Test Results

Receiving test results

It will typically take two to three business days to receive the results of your anti-dsDNA test, although this timeline will depend on where your test is performed. You may need additional testing to get a definitive diagnosis, but your doctor can help you determine if this is the case.

When you order the test directly through a lab, you will usually receive your results online. If you go through your doctor’s office, they will notify you when your results are ready.

Interpreting test results

The results of an anti-dsDNA test are usually considered with a person’s medical history, signs and symptoms, and results of other autoantibody tests.

A high level of anti-dsDNA in the blood is strongly associated with lupus and is often significantly increased during or just prior to a flare-up. When the anti-dsDNA is positive and you have other clinical signs and symptoms associated with lupus, it means that you likely have lupus. This is especially true if an anti-Sm test is also positive.

In the evaluation of someone with lupus nephritis, a high level (titer) of anti-dsDNA is generally associated with ongoing inflammation and damage to the kidneys.

A very low level of anti-dsDNA is considered negative but does not exclude a diagnosis of lupus. Only about 65-85% of those with lupus will have anti-dsDNA.

Low to moderate levels of the autoantibody may be seen with other autoimmune disorders, such as Sjögren’s syndrome and mixed connective tissue disease (MCTD).

Helpful questions to ask your doctor about your test result may include:

  • Why might it take a long time to be diagnosed with lupus?
  • If I have been diagnosed with lupus, will it ever be cured?
  • Will my anti-dsDNA ever go away?
  • Is there anything else I can do to affect my anti-dsDNA level?



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