Test Details: To evaluate patients at risk for antinuclear antibodies-associated systemic autoimmune rheumatic disease particularly systemic lupus erythematosus, Sjogren syndrome and mixed connective tissue disease. A large number of healthy individuals have weakly-positive antinuclear antibody (ANA) enzyme-linked immunosorbent assay (ELISA) results, many of which are likely to be clinical false-positive results; therefore, second-order testing of all positive ANA yields a very low percentage of positive results to extractable nuclear antigens including double-stranded (ds) DNA. Positive ANA results are associated with the presence of detectable autoantibodies to specific extractable nuclear antigens (SM, SS-A, SS-B, Sm/RNP or RNP 68 and RNP A, Jo-1, Scl-70) including dsDNA.