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Research Ana Pattern
Quest Diagnostics Quest Diagnostics Systemic lupus erythematosus (SLE)

Ana Pattern

Reference range:

Nuclear, membrane Nuclear, centromere Nuclear, homogenous Nuclear, nucleolar Nuclear, proliferating cell nuclear antigen (PCNA), speckled Nuclear dots (1-6 per cell) Nuclear dots (6-20 per cell) Cytoplasmic, cytoskeletal Cytoplasmic, golgi apparatus Cytoplasmic, lysosomal Cytoplasmic, mitochondrial Cytoplasmic, ribosomal Nuclear, Dense Fine Speckled Cytoplasmic, Discrete Dots/GW body Mitotic, Spindle Fibers

Usually, the results of the ANA test are reported in titers and patterns. The titer gives information about how many times the lab technician diluted the blood plasma to get a sample of ANAs.

The pattern of the ANA test can give information about the type of autoimmune disease present and the appropriate treatment program.

A homogenous (diffuse) pattern appears as total nuclear fluorescence and is common in people with systemic lupus. A peripheral pattern indicates that fluorescence occurs at the edges of the nucleus in a shaggy appearance; this pattern is almost exclusive to systemic lupus. A speckled pattern is also found in lupus. Another pattern, known as a nucleolar pattern, is common in people with scleroderma.

The ANA staining pattern can be helpful in suggesting a diagnosis, but does not provide definitive evidence.

What does it mean if your result is Nuclear, membrane?

The pattern is associated with a number of autoimmune mediated diseases, namely AIH, PBC, SLE and APS. An antigen that can give rise to a NM pattern is gp210. The antibody directed against gp210 is specific for PBC and , PBC patients who are gp210 antibody positive, typically have a more aggressive and severe form of the disease.

What does it mean if your result is Nuclear, centromere?

The ANA staining is seen along the chromosomes. This pattern can be associated with limited systemic sclerosis, primary biliary cirrhosis, and other autoimmune diseases like Raynaud's Phenomenon.

What does it mean if your result is Nuclear, homogenous?

A "Nuclear, homogenous" ANA pattern is characterized by a uniform staining of the cell nucleus, indicative of the presence of antinuclear antibodies. This pattern is often associated with systemic lupus erythematosus (SLE) and can also be seen in other autoimmune diseases like mixed connective tissue disease. It suggests the presence of antibodies against components like chromatin, histones, and double-stranded DNA, with a strong link to SLE when dsDNA antibodies are present. However, this pattern is not exclusively diagnostic of any single condition and must be interpreted alongside clinical symptoms and additional tests for an accurate diagnosis.

What does it mean if your result is Nuclear, nucleolar?

The ANA staining is seen around the nucleoles inside the nucleus. This can be seen in Systemic Sclerosis.

What does it mean if your result is Nuclear, proliferating cell nuclear antigen (PCNA), speckled?

This is an example of a cell cycle dependent speckled ANA pattern called proliferating cell nuclear antigen (PCNA). With this pattern the antigen that the antibodies are directed to is only expressed during a limited portion of the cell's growth cycle. During other parts of the growth cycle the antigen is not expressed. This creates a pattern where only 30-50% of the cells stain positive. The speckled staining within these positive cells varies between coarse speckled (a) and smooth speckled (b). Cells not expressing the antigen are negative (c). Follow-up testing to confirm antibodies to PCNA is recommended. Anti-PCNA antibodies are specific for SLE.

What does it mean if your result is Nuclear dots (1-6 per cell)?

Consistent with Sjogren syndrome, SLE, systemic sclerosis, polymyositis, and asymptomatic individuals.

What does it mean if your result is Nuclear dots (6-20 per cell)?

Consistent with primary billiary cholangitis, polymyositis/dermatomyositis, and other systemic autoimmune rheumatic disease.

What does it mean if your result is Cytoplasmic, cytoskeletal?

Associated with autoimmune liver disease (anti-smooth mucle); myasthenia gravis, Crohn disease, and long-term hemodialysis; alcoholic liver disease, rheumatoid arthritis, and psoriasis (anti-keratin).

What does it mean if your result is Cytoplasmic, golgi apparatus?

Consistent with SLE, Sjogren syndrome, cerebellar disease, and viral infections.

What does it mean if your result is Cytoplasmic, lysosomal?

Unknown clinical significance.

What does it mean if your result is Cytoplasmic, mitochondrial?

Suggestive of antimitochondrial antibody presence and primary biliary cholangitis.

What does it mean if your result is Cytoplasmic, ribosomal?

Unknown clinical significance; may be associated with neuropsychiatric lupus

What does it mean if your result is Nuclear, Dense Fine Speckled?

Dense fine speckled pattern is seen in normal individuals and rarely associated with systemic lupus erythematosis (SLE), Sjogren's syndrome and systemic sclerosis.

What does it mean if your result is Cytoplasmic, Discrete Dots/GW body?

Pattern is associated with primary biliary cholangitis (PBC), systemic autoimmune rheumatic diseases (SARD), neurological conditions, and other autoimmune conditions.

What does it mean if your result is Mitotic, Spindle Fibers?

A Mitotic Spindle Fibers pattern on an ANA (Antinuclear Antibody) panel indicates the presence of autoantibodies targeting components of the mitotic spindle apparatus, a structure essential for chromosome segregation during cell division. This pattern is observed under a fluorescence microscope, where staining appears localized to spindle fibers or related mitotic structures. It is notably rare, with reported prevalence rates of less than 0.5% among ANA-positive samples. The pattern is associated with autoantibodies that often target proteins such as the nuclear mitotic apparatus protein (NuMA) or centrosome components. While initially linked to specific autoimmune conditions like systemic lupus erythematosus or Sjögren's syndrome, recent research suggests its clinical associations are not fully established and may vary. It has been observed in patients with various autoimmune disorders, including rheumatoid arthritis and undifferentiated connective tissue disease, as well as occasionally in non-autoimmune conditions. Importantly, the Mitotic Spindle Fibers pattern can coexist with other ANA patterns, which may influence its interpretation. The clinical relevance of this finding depends heavily on the context of symptoms, other serological markers, and overall clinical presentation. Due to its rarity and evolving understanding, further testing is typically warranted. This may include an ENA (Extractable Nuclear Antigen) panel or specific antibody assays. Clinicians should interpret this pattern cautiously, considering it as one piece of a broader diagnostic puzzle. Careful correlation with clinical symptoms and additional laboratory findings is essential to assess its significance and guide diagnosis or management strategies. As research in this area continues, our understanding of the pattern's implications may further evolve.

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