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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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Mixed ANA Patterns: Overview

The presence of more than one ANA pattern in a sample is referred to as a mixed ANA pattern.

The most common of these is a mixture of Homogeneous and Speckled, but any combination is possible.

Frequently, titering the sample will facilitate the identification of multiple patterns and allow for each pattern to be identified. When multiple patterns are encountered, each pattern and its respective titer should be reported. Follow-up testing should be suggested based on the patterns present. In many cases both anit-dsDNA and anti-ENA testing are suggested.

About Mixed ANA patterns:

  • They can be any combination of patterns.
  • The viewer may only see one pattern at first.
  • Mitotics may be hard to find.
  • Tittering helps to separate patterns and makes identification easier.
  • Report all patterns and respective titers.
  • Suggest follow-up testing based on patterns.