INDIVIDUAL TEST 020

ANA screen (HEp-2 cells)

IndicationSuspicion of collagenosis diseases, systemic lupus erythematosus, scleroderma, mixed connective tissue disease, primary Sjögren’s syndrome, chronic active hepatitis, hypergammaglobulinemic purpura, juvenile rheumatoid arthritis, drug induced lupus.MethodIndirect immunofluorescence with human epithelial cells (HEp-2 cells).AnswerThe result is graded as negative, 1+ (slightly positive), 2+ (positive), 3+ (strongly positive) according to fluorescence intensity and is assessed into different patterns.Interpretation - Pattern

• Homogeneous. ANA with homogeneous pattern is associated to several rheumatic diseases and autoimmune liver disease. Approximately 5% of a healthy population normal serum show weak unspecific patterns. Samples with homogeneous ANA will be further analyzed for anti-dsDNA, anti-histones and anti-ENA (anti-Sm, anti-nRNP, anti-SSA, anti-SSB, anti-Scl-70, anti-Jo1 and anti-Ro 52).
• Speckled. ANA with speckled pattern is associated to several rheumatic diseases and autoimmune liver disease. Approximately 5% of a healthy population normal serum show weak unspecific patterns. Samples with speckled ANA will be further analyzed for anti-dsDNA and anti-ENA (anti-Sm, anti-nRNP, anti-SSA, anti-SSB, anti-Scl-70, anti-Jo1 and anti-Ro 52).
• Nucleolar. ANA with nucleolar pattern is primarily marker of systemic sclerosis of diffuse type, but slightly positive findings can also be seen in other conditions.
• Centromere. ANA with centromere pattern is primarily a marker for systemic sclerosis of limited type but are also seen in other rheumatic system diseases and in primary biliary cholangitis (PBC).
• Proliferating cell nuclear antigen (PCNA). ANA with PCNA pattern is an unusual subtype of ANA but is regarded to have high specificity for SLE.
• Nuclear dots. In the presence of ANA with nuclear dots pattern, further analysis of antibodies associated with primary biliary cholangitis (PBC) is recommended. Cholestatic liver tests?
• Nuclear membrane. In the presence of ANA with nuclear membrane pattern, further analysis of autoantibodies associated with primary biliary cholangitis (PBC) is recommended. Cholestatic liver tests?