MitogenDx does not recommend repeating a Hep-2 IFA or ENA test until at least 6 months has passed from a previous blood draw and subsequent test. However, if there is a compelling clinical reason an additional ENA or HEp-2 IFA test may be of insightful. Repeated ANA and autoantibody profile tests are most useful in the diagnostic phase of patient evaluations (i.e. sera with initially negative or low titer positive ANA from a patient with a clinically defined systemic autoimmune disease). A repeat ANA or disease specific autoantibody profile is not indicated unless a change in the clinical picture raises the suspicion of a change in the underlying disease presentation or the appearance of another associated rheumatic disease (e.g. secondary Sjögren’s syndrome, secondary anti-phospholipid syndrome or an overlap syndrome, vasculitis, sudden appearance of Raynaud’s phenomenon).