This serum sample is negative for anti-nuclear and anti-cytoplasmic antibodies at a 1:40 dilution on a human epithelial cell substrate (Hep-2 cells).
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High Titer (greater than 1:80)
Homogeneous
High titered (1:160 or greater) homogeneous pattern is suggestive of idiopathic or drug induced SLE. Lower levels are seen in other connective tissue diseases. Specific tests to quantitate antibodies to dsDNA and DNP can be ordered if clinically warranted.
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LOW Titer (less than 1:80) Homogeneous
ANA of the homogeneous pattern is suggestive of idiopathic or drug induced SLE. However, low levels, such as this, are seen in other connective tissue diseases. Specific tests to quantitate antibodies to dsDNA and DNP can be ordered if clinically warranted.
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High Titer (greater than 1:80) Speckled
Pattern
High titered (> 1:80) speckled pattern suggests antibodies to extractable nuclear antigens (ENA). ENA testing in this laboratory includes Sm (associated with SLE), RNP (Mixed Connective Tissue Disease), SSA (Sjogren's Syndrome-SICCA complex and SLE) and Scl-70 (scleroderma). Specific assays for Sm, RNP, SSA, SSB or Scl-70 can be ordered.
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Low Titer (1:40) Speckled Pattern
Sera from some individuals with no apparent connective tissue disease have low titered speckled ANA's. The incidence and titers in these individuals increase with age. If an autoimmunce connective tissue disease is suspected, a repeat ANA is suggested on follow-up visit to determine if the titer is rising.
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Atypical Speckled Pattern
Atypical speckled pattern includes a number of ANA patterns that are distinct from a true speckled reaction pattern and which as yet have no known clinical significance. The antigens involved in these patterns have not been identified.
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Anti-Nucleolar Pattern
Anti-Nucleolar antibodies are found in 60-70% of scleroderma-systemic sclerosis patients, 26% SLE patients and 9% rheumatoid arthritis patients and rarely seen in conjunction with other connective tissue diseases.
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Centromeric Pattern
The presence of anti-centomere antibodies is associated with the CREST variant of scleroderma (seen in 57-98% of patients with CREST). It is also found in patients with Raynaud's syndrome alone or in association with other connective tissue diseases, and in 10% of patients with diffuse scleroderma.
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Centriole Pattern
Suspect anti-centriole antibody on Hep-2 cell substrate. Antibody to the centriole has been described in patients with scleroderma, but the exact disease specificity has not been defined.
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Mitotic Spindle Fiber Pattern
The sample is positive for antibodies to Mitotic Spindle Fiber Apparatus (MSA) on Hep-2 substrate. The clinical significance of MSA antibody has not been clearly defined. It has been seen in patients with Carpal Tunnel Syndrome, SLE, and other connective tissue diseases.
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Nuclear Membrane Pattern
The disease association of antibodies to nuclear membrane antigens is unknown.
Antibodies directed against Proliferating Cell Nuclear Antigens (PCNA) are rare. They have been found in 3% of patients with SLE.
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Golgi Apparatus Pattern
Suspect antibody to the golgi apparatus on Hep-2 cell substrate. In a study of 8 patients with anti-golgi antibodies, 6 had SLE.
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Peripheral Pattern
A peripheral ANA pattern has the same antigen association as a homogeneous pattern. High titered (1:160 or greater) peripheral pattern is suggestive of idiopathic or drug induced SLE. Lower levels are seen in other connective tissue diseases. Antibodies to dsDNA and DNP can be quantitated if clinically warranted.
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Nuclear Matrix Pattern
Antibodies to nuclear matrix have been seen in patients with evolving or overlapping systemic rheumatic diseases, and in 35% of patients with primary SICCA syndrome. It has been seen in conjunction with speckled pattern in Mixed Connective Tissue Disease (MCTD).
Antibody to Primary Biliary Cirrhosis-associated Nuclear Antigen (PBCNA) detected on Hep-2 cell substrate.
Antibody to midbody is seen predominantly in progressive systemic sclerosis patients (PSS). 2% of PSS patients exhibit this antibody.
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Cytoplasmic Pattern
This serum shows a positive reaction with a cytoplasmic antigen on the Hep-2 cell substrate. Tests can be ordered for smooth muscle or mitochondria antibodies if clinically warranted.