Speckled (AC-5)

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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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Speckled (AC-5)

This pattern is characterized by granular/speckled staining in the nucleus of the interphase cells (a). The nucleoli do not stain. Notice the absence of staining in the chromosomal area of the metaphase mitotic cells (b) and some speckling in the area outside of the chromosomal area.
Follow-up testing for antibodies to the extractable nuclear antigens (ENAs) such as Sm, U1-RNP, SSA/Ro, SSB/LA, and Scl-70 is recommended. These antibodies are seen in a variety of patients, including those with SLE (Sm, SM/RNP, SSA/Ro, and SSB/La), Sjögren's syndrome (SSA/Ro and SSB/La), and systemic sclerosis (Scl-70).
This pattern is reported as "ANA positive, Speckled; titering is necessary."
Interphase cells
  • Speckled staining in nucleus
  • May be coarse, fine, or mixture of both
  • Nucleoli do not stain
Metaphase mitotic cells
  • No staining in the chromosome region
  • Region outside of the chromosome area will stain with variable intensity