What this test measures
After a positive ANA screen, the lab dilutes the sample in serial 2-fold dilutions (1:80, 1:160, 1:320, 1:640, 1:1280, 1:2560+) until fluorescence is no longer visible. The last dilution showing positivity is reported as the titre. Higher titres are more strongly associated with autoimmune disease, but pattern + clinical context remain essential.
Why it matters
Same indications as ANA screening — connective tissue disease workup (SLE, Sjögren's, scleroderma, MCTD, autoimmune hepatitis, polymyositis). The titre adds prognostic and diagnostic information: low titres are common in healthy people; very high titres are rare without autoimmune disease.
How to prepare
Same as ANA screening. No fasting. Stop biotin supplements 48-72h before. Disclose pregnancy, infection, recent vaccination, immunosuppression.
Markers & reference ranges
Reference ranges below are typical adult values. Your lab's reported range may differ slightly based on the assay platform and patient demographics — always read your report against the range printed on it.
| Marker | Normal range | If low | If high |
|---|---|---|---|
| ANA Titre (Titre)[1][2] | Negative (< 1:80) | < 1:80 — negative. | 1:80 – 1:160: low — common in healthy adults; clinical correlation. 1:320 – 1:640: moderate — supports autoimmune disease in suggestive clinical context. ≥ 1:1280: high — strongly suggests CTD; order specific autoantibody panel based on the pattern (anti-dsDNA, anti-ENA, anti-centromere, etc.). |
ANA titre interpretation
| Titre | Probability of CTD | Action |
|---|---|---|
| < 1:80 | Very low | No follow-up unless clinically suspicious |
| 1:80 – 1:160 | Low — common in healthy | Clinical correlation |
| 1:320 – 1:640 | Moderate | Investigate based on pattern |
| ≥ 1:1280 | High | Full autoimmune workup (anti-dsDNA, anti-ENA, complement) |
Frequently asked questions
How is the titre measured?
Serial 2-fold dilution until fluorescence disappears. The last positive dilution is reported (e.g. 1:320 means visible at 1:320 but negative at 1:640).
Does higher titre = worse disease?
Generally yes for diagnosis, but titre doesn't track activity well. Use anti-dsDNA and complement for SLE monitoring, not ANA titre.
My titre is 1:160 — is that worrying?
1:80–1:160 is a common low-titre finding in healthy older adults and after some infections. Without symptoms or pattern suggestive of CTD, it usually doesn't need follow-up.
Will titre change over time?
In treated SLE on stable therapy, titre often persists at chronic moderate level. Major changes are unusual and not reliable activity markers.
Why is pattern reported alongside titre?
Pattern (homogeneous, speckled, nucleolar, centromere, cytoplasmic) directs which specific antibodies to test next. Two patients with the same titre but different patterns get different workups.
Related Autoimmune / Rheumatology tests
Tests commonly ordered alongside ANA TITRE (IMMUNOFLUORESCENCE), or that help interpret an unexpected result.
Sources & references
- ACR — ANA Position Statement · accessed 2026-05-30T00:00:00.000Z
- ANA IIF Patterns Consensus · accessed 2026-05-30T00:00:00.000Z
- Mayo Clinic Labs — ANA IFA · accessed 2026-05-30T00:00:00.000Z
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