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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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Centromere (AC-3)

This is an example of a centromere ANA pattern.

This pattern is characterized by staining of discrete speckles in the nucleus of the interphase cells (a). This is staining of the centromere. There are usually 46 speckles, one for each set of chromosomes. Notice the discrete speckling is also seen in the chromosomal area of the metaphase mitotics (b).

The presence of anti-centromere antibodies can be determined by the staining pattern alone. No specific follow-up testing is necessary. Anti-centromere antibodies are most often seen in patients with the limited form of systemic sclerosis called the CREST syndrome. CREST is an acronym for the clinical features:

Calcinosis cutis

Raynaud's phenomenon

Esophageal dysfunction



Anti-centromere antibodies have been detected years prior to the onset of symptoms. Finding these antibodies in patients with Raynaud's phenomenon or other risk factors is an important indicator for the potential development of systemic sclerosis.

This pattern is reported as "ANA positive Centromere; titering is necessary."


Interphase cells

  • Usually 46 discrete speckled
  • Evenly distributed in the nucleus

Metaphase mitotic cells

  • Discrete speckles align in the chromosomal region of the mitotics
  • No staining outside of the chromosomal area