The importance of distinguishing atypical cytoplasmic indirect immunofluorescence patterns from the “classic”, centrally accentuated cytoplasmic immunofluorescence pattern on ethanol fixed human neutrophils has recently been re-emphasised.^1–3 Autoantibodies to other cytoplasmic autoantigens such as antimitochondrial antibodies (AMA), antismooth muscle antibodies, and antiribosomal-P antibodies have also recently been reported to produce atypical cytoplasmic immunofluorescence patterns on ethanol fixed human neutrophils.¹ However, an alternative explanation is that the atypical cytoplasmic immunofluorescence patterns might be produced by concomitant antineutrophil cytoplasmic antibodies (ANCA) in these sera, especially in cases of autoimmune liver disease. Therefore, we investigated: (1) whether sera containing AMA with confirmed M2 specificity⁴ produced positive indirect immunofluorescence …