Pattern observed by indirect immunofluorescence | Antigen | Disease(s) in which antibodies are seen | Routine tests used to confirm specific antibody |
Homogeneous | Double stranded DNA (dsDNA) | Characteristic of SLE, lower levels in other rheumatic diseases | IFA or CZ using Crithidia luciliae, ELISA, addressable laser bead assay (ALBIA) |
Nucleosome or chromatin | SLE, drug-induced LE | ELISA |
Histone | Drug-induced LE, SLE | ELISA, ALBIA |
Unusual homogeneous | Nuclear membrane | Lupoid hepatitis | ELISA for gp-210 |
Speckled | Sm (Smith) | Marker antibody for SLE | Immunodiffusion (ID), ELISA, ALBIA |
U1-RNP | High levels in MCTD and SLE, low levels in other rheumatic diseases | ID, ELISA, ALBIA |
Speckled (and/or SSA pattern if using HEp-2000®) -can also be ANA negative | SS-A/Ro | High prevalence in Sjögren's syndrome sicca complex, lower prevalence in other rheumatic diseases | With HEp-2000 characteristic ANA pattern is confirmatory, others confirm with ID, ELISA, ALBIA |
Fine speckled or ANA negative | Ro52 | Sjögren's syndrome, myositis, Neonatal Lupus | ELISA, ALBIA |
Fine speckled (sometimes with nucleolar staining as well) | SS-B/La | High prevalence in Sjögren's syndrome sicca complex, lower prevalence in other rheumatic diseases | ID, ELISA, ALBIA |
Fine speckled, homogeneous, nucleolar | Scl-70 | Marker antibody for Scleroderma | ID, ELISA, ALBIA |
Cell cycle dependent speckled | PCNA | Marker antibody for SLE | ID, ELISA, ALBIA |
Coarse speckled | Nuclear matrix | Seen in some patients with evolving connective tissue disease | None |
3-20 dots | NSp I, sp-100, MND, PBC 95 | Associated with primary biliary cirrhosis | ELISA, ALBIA |
Cell cycle dependent speckled with speckling in metaphase mitotics | NSp II, CENP F | Some association with malignancies | None |
Staining in cleavage furrow between dividing cells | Midbody | Unknown | Confirm by staining pattern |
Centromere | CENP A, CENP B, CENP C | Seen in 57-82% of patients with limited form (CREST) of scleroderma and Raynaud phenomenon | Confirmed by staining pattern ELISA, ALBIA |
Nucleolar | Fibrillarin (clumpy nucleolar) | Scleroderma | ELISA, ALBIA |
RNA polymerase I, NOR-90, others? (speckled nucleolar) | Scleroderma and other connective tissue diseases | ELISA, ALBIA |
PM-1 (PM/Scl), others? (smooth nucleolar) | Polymyositis/Scleroderma overlap | ELISA, ALBIA |