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The page below is a sample from the LabCE course Autoimmune Diseases and Antinuclear Antibody Testing: Methods and Staining Patterns. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Antigen Chart

Pattern observed by indirect immuno fluorescenceAntigenDisease(s) in which antibodies are seenRoutine tests used to confirm specific antibody
HomogeneousDouble stranded DNA (dsDNA)Characteristic of SLE, lower levels in other rheumatic diseasesIFA or CZ using Crithidia luciliae, ELISA, addressable laser bead assay (ALBIA)
Nucleosome or chromatinSLE, drug-induced LEELISA
HistoneDrug-induced LE, SLEELISA, ALBIA
Unusual homogeneousNuclear membraneLupoid hepatitisELISA for gp-210
SpeckledSm (Smith)Marker antibody for SLEImmunodiffusion (ID), ELISA, ALBIA
U1-RNPHigh levels in MCTD and SLE, low levels in other rheumatic diseasesID, ELISA, ALBIA
Speckled (and/or SSA pattern if using HEp-2000®)-Can also be ANA negativeSS-A/RoHigh prevalence in Sjögren syndrome sicca complex, lower prevalence in other rheumatic diseasesWith HEp-2000 characteristic ANA pattern is confirmatory, others confirm with ID, ELISA, ALBIA
Fine speckled or ANA negativeRo52Sjögren syndrome, myositis, Neonatal LupusELISA, ALBIA
Fine speckled (sometimes with nucleolar staining as well)SS-B/LaHigh prevalence in Sjögren syndrome sicca complex, lower prevalence in other rheumatic diseasesID, ELISA, ALBIA
Fine speckled, homogeneous, nucleolarScl-70Marker antibody for SclerodermaID, ELISA, ALBIA
Cell cycle dependent speckledPCNAMarker antibody for SLEID, ELISA, ALBIA
Coarse speckledNuclear matrixSeen in some patients with evolving connective tissue diseaseNONE
3-20 dotsNSp I, sp-100, MND, PBC 95Associated with primary biliary cirrhosisELISA, ALBIA
Cell cycle dependent speckled with speckling in metaphase mitoticsNSp II, CENP FSome association with malignanciesNONE
Staining in cleavage furrow between dividing cellsMidbodyUnknownConfirm by staining pattern
CentromereCENP A, CENP B, CENP CSeen in 57-82% of patients with limited form (CREST) of scleroderma and Raynaud phenomenon Confirmed by staining pattern ELISA, ALBIA
NucleolarFibrillarin (clumpy nucleolar)SclerodermaELISA, ALBIA
RNA polymerase I, NOR-90, others? (speckled nucleolar)Scleroderma and other connective tissue diseasesELISA, ALBIA
PM-1 (PM/Scl), others?(smooth nucleolar)Polymyositis/Scleroderma overlapELISA, ALBIA