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ANA Pattern

1. The document describes 28 different antinuclear antibody (ANA) patterns seen on indirect immunofluorescence assays, including the specific antigens recognized, associated diseases, and staining characteristics. 2. The ANA patterns are grouped based on their nuclear, nucleolar, cytoplasmic, or mitotic staining properties. Common nuclear staining patterns recognize antigens like DNA, centromere proteins, and spliceosome proteins and are seen in diseases like systemic lupus erythematosus. 3. Nucleolar staining patterns recognize antigens such as PM-Scl, Th/To, and RNA polymerases and are associated with diseases such as systemic sclerosis. Cytoplasmic patterns recognize cytoskeletal proteins, mitochondria,

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0% found this document useful (0 votes)
63 views2 pages

ANA Pattern

1. The document describes 28 different antinuclear antibody (ANA) patterns seen on indirect immunofluorescence assays, including the specific antigens recognized, associated diseases, and staining characteristics. 2. The ANA patterns are grouped based on their nuclear, nucleolar, cytoplasmic, or mitotic staining properties. Common nuclear staining patterns recognize antigens like DNA, centromere proteins, and spliceosome proteins and are seen in diseases like systemic lupus erythematosus. 3. Nucleolar staining patterns recognize antigens such as PM-Scl, Th/To, and RNA polymerases and are associated with diseases such as systemic sclerosis. Cytoplasmic patterns recognize cytoskeletal proteins, mitochondria,

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Table 10: AC Patterns (www.anapatterns.

org)
AC Nucleus Chromatin Nucleolus Specific ANA Associated autoinflammatory
Pattern staining stained? stained? diseases
+ yes; - no; or other conditions
+/- both possible
Nuclear
1 Nuclear + +/- Nucleosome SLE, drug induced Lupus, AIH, JIA
homogenous (dsDNA, ssDNA,
histone)
2 Nuclear dense + - DFS70/ LEDGF apparently healthy individuals (if no
fine speckled other specific ANA)
3 Centromere ++ - CENP-A/B limited SSc (SjS, SLE, PBC)
(coarse
speckles, 40-
80)
4 Nuclear fine - +/- SS-A/B, SS-A/B: SjS, SLE, subacute cutaneous
speckled Mi-2, TIF1γ, TIF1β, lupus, neonatal lupus
Ku Mi-2/Tif: DM
Ku: SLE/ SSc-IIM overlap syndrome,
(SLE)
5 Nuclear - +/- Sm, U1RNP, Sm: SLE
large/coarse RNA polymerase III U1RNP: MCTD, SLE, SSc/IIM-Overlap
speckled RNA Polymerase III: SSc (diffuse)
6 Multiple - - Sp-100, PML broad spectrum,
nuclear dots proteins, MJ/NXP-2 SP-100/PML: PBC, MJ/NXP-2: IIM
(6-20) (DM: specific)
7 Few nuclear - - p80-coilin, SMN p80‐coilin: rarely in SLE, SSc, and SjS
dots (1-6) (survival of motor SMN: rarely in IIM or SSc‐AIM
neurons protein) overlap syndrome
Nuclear with nucleolar staining
8 Homogenous - + PM/Scl-75, PM/Scl- PM/SCL: SSc, IIM, SSc-IIM overlap
nucleolar 100, Th/To. (SLE, SjS)
B23/nucleophosmi anti-Th/To: SSc (limited), SLE (IIM,
n, nucleolin, UCTD SSc sine scleroderma,
No55/SC65 idiopathic interstitial lung disease)
others: significance unknown
9 Clumpy peri- + U3-RNP/fibrillarin SSc (diffuse, PAH, severe course,
nucleolar chromosomal African American, Latin American
patients)
10 Punctate - + RNA polymerase I, SSc, (SjS); RNA pol I (together with
nucleolar NOR-90 RNA pol III)
Other nuclear patterns
11 Smooth - - lamins A, B, C Infrequent, e.g.
nuclear lamin-associated PBC, autoimmune-cytopenias, liver
envelope proteins diseases, linear scleroderma,
antiphospholipid syndrome
12 Punctate - - nuclear pore gp 210: PBC
nuclear complex proteins p62: PBC, SLE
envelope (gp210, p62, LBR, LBR: PBC
Tpr) Tpr: PBC, autoimmune liver diseases,
SLE, SSc, SjS
13 PCNA-like perichromosomal - PCNA SLE
(pleomorphic (SSc, AIM, RA, HCV)
speckled
nucleoplasmic
staining)

1
EULAR | Education
Seestrasse 240 | 8802 Kilchberg | Switzerland
T: +41 44 716 30 30
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14 CENP-F like Mitotic cells - CENP-F Crohn’s disease, autoimmune liver
(nuclear stained disease, SjS,
speckled) graft-versus-host disease, several
malignancies
Cytoplasmatic
15 Cytoplasmatic - - (F-)actin, AIH type 1, chronic HCV, celiac
fibrillar linear non-muscle myosin disease
16 Cytoplasmatic - - cytokeratin, not typically found in connective
fibrillar vimentin, tissue diseases
filamentous tropomyosin cytokeratin: HCV, COPD, pulm.
fibrosis
vimentin: Neurofibromatosis
cycl. vimentin: Rheumatoid arthritis
17 Cytoplasmatic - - alpha-actinin, actinin: SLE, AIH Type I
fibrilllar vinculin vinculin: chronic inflammatory
segmental demyelinating neuropathy
18 Cytoplasmatic - - GW (182) variety of diseases, neurolog.
discrete dots symptoms
19 Cytoplasmatic - - PL-7, PL-12, PL-7/12: anti-synthetase syndrome
dense fine ribosomal P ribosomal P Proteins: SLE, AIH
speckled proteins
20 Cytoplasmatic - - Jo-1 antisynthetase syndrome
fine speckled
21 Cytoplasmatic - - mitochondrial Often: PBC, also SSc, PBC-SSc
reticular/ structures: PDC- overlap/ PBC-SjS overlap
anti E2/M2, BCOADC-
mitochondrial E2, OGDC-E2, E1α,
(AMA) E3BP/protein X
22 Polar/Golgi- - - golgi structures: variety of conditions
Like giantin/macrogolgi low percentage:
n, golgin- SjS, SLE, RA, MCTD, GPA, idiopathic
95/GM130, golgin- cerebellar ataxia, paraneoplastic
160, golgin-97, cerebellar degeneration, adult onset
golgin-245 Still’s disease, viral infections
23 Rods an rings - - IMPDH2 HCV patients
Mitotic positive: mitotic cells are stained
24 Centrosome - - pericentrin, ninein, Low percentage:
Cep250, Cep110 localized scleroderma, SSc, Raynaud,
SLE
25 Spindle fibres - - HsEg5 SjS and SLE (not specific)
26 NuMa like - - NuMa SjS, SLE, UCTD, limited SSc, or RA
(Nuclear
speckled
staining with
spindle fibers)
27 Intercellular - - CENP-E, CENP-F, very rare
bridge TD60, MSA36, KIF- SSc (limited and diffuse),
„Midbody“ 14, MKLP-1, Raynaud’s phenomenon, SLE,
MPP1/KIF20B malignancies, neurological diseases
28 Mitotic + - DCA, MCA-1,5, DCA: SLE
chromosomal (pro/metaphase) modified histone, MCA1: malignancies
H3 MCA5: discoid lupus erythematosus,
chronic lymphocytic leukaemia, SjS,
polymyalgia rheumatica
29 DNA - + + DNA- Ssc (diffuse)
topoisomerase topoisomerase
/SCL70

2
EULAR | Education
Seestrasse 240 | 8802 Kilchberg | Switzerland
T: +41 44 716 30 30
[email protected] | esor.eular.org

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