Table 5

Common antinuclear antibody (ANA) HEp-2 patterns and their clinical use in SLE

PatternAutoantibody associationClinical association
The main use of the ANA pattern on screening is to determine the need for further antibody specificity testing or to distinguish possible false positive ELISA.
Patterns are not diagnostic, most homogenous or speckled ANAs have no detectable dsDNA or ENA antibodies.
AICAH, autoimmune chronic active hepatitis; dsDNA, double stranded DNA; ENA, extractable nuclear antigen; IIF, immunofluorescence; MCTD, mixed connective tissue disease; RNP, ribonuclear protein; SCLE, subacute cutaneous lupus erythematosus; ssDNA, single stranded DNA.
HomogenousdsDNA, ssDNA, histones, nucleosomes, KuSLE, AICAH, and many non-pathological ANAs
Rim/peripheraldsDNA, laminin, nuclear poreSLE/AICAH
Speckled (coarse)RNP/SmSLE/MCTD
Speckled (fine) may be missed on IIF owing to variable Ro expression on tissueRo/La (also cytoplasmic)SLE/SCLE/scleroderma
Speckled (centromere)Centromere A, B, C kinetechore proteinsPrimary Raynauds, scleroderma, SLE