ANA Patterns

smooth, even glow of the entire nucleus

Pattern: Homogenous/Diffuse

Target Antigens: dsDNA + Histones

Disease Association: SLE, Drug-induced

Significance: suspect lupus

bright dots scattered in nucleus

Pattern: Speckled

Target Antigens: Sm, RNP, SSA (Ro), SSB (La)

Disease Association: SLE (SM, RNP, Ro), Sjogrens (SSA/SSB), MCTD (RNP), Scleroderma (overlap)

Significance: think autoimmune, most common and least specific

bright, glowing nucleoli, bubbles

Pattern: Nucleolar

Target Antigens: RNA polymerase, PM-Scl, Fibrillarin

Disease Association: Systemic sclerosis, CREST, Polymyositis-scleroderma overlap

Significance: skin thickening → scleroderma spectrum disorder

discrete dots in nucleus (40-60)

Pattern: Centromere

Target Antigens: anti-Centromere antibody

Disease Association: Limited scleroderma (CREST)

• Calcinosis, Raynaud’s, Esophageal issues, Sclerodactyly, Telangiectasia

Significance: C=C (centromere = crest), slow progression to systemic sclerosis

bright ring around the outside of the nucleus

Pattern: Peripheral (Rim)

Target Antigens: anti-dsDNA

Disease Association: SLE (highly specific)

Significance: renal lupus, correlated with kidney damage

• periphERY = dsDNA = slE kidNEY involvement

cytoplasm lights up rather than nucleus

Pattern: Cytoplasmic

Target Antigens: tRNA synthetases (antiJo-1), Ribosomal proteins, Actin

Disease Association: Polymyositis, Dermatomyositis, AI hepatitis

Significance: muscle disease*