Common antinuclear antibody (ANA) HEp-2 patterns and their clinical use in SLE
| Pattern | Autoantibody association | Clinical 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. | ||
| Homogenous | dsDNA, ssDNA, histones, nucleosomes, Ku | SLE, AICAH, and many non-pathological ANAs |
| Rim/peripheral | dsDNA, laminin, nuclear pore | SLE/AICAH |
| Speckled (coarse) | RNP/Sm | SLE/MCTD |
| Speckled (fine) may be missed on IIF owing to variable Ro expression on tissue | Ro/La (also cytoplasmic) | SLE/SCLE/scleroderma |
| Speckled (centromere) | Centromere A, B, C kinetechore proteins | Primary Raynauds, scleroderma, SLE |