Diseases associated with the different patterns of antinuclear antibodies detected by immunofluorescence

Abstract AR

Backgrounds: Immunofluorescent antinuclear antibody (ANA) patterns are variable and may indicate specificity towards certain diagnoses.

Objectives: To explore the spectrum of diseases associated with the common different ANA patterns seen at King Abdulaziz University Hospital (KAUH).

Methods: ANA tests were performed by indirect immunofluorescent assay (UFA) in the clinical immunology laboratory.

Cases with positive ANA were selected sequentially.

Their UFA patterns and patient files were reviewed.

Resulls: 211 positive ANA cases were studied.

The ages ranged between 3- females predominated (83%).

Rheumatological disorders were the predominant illnesses; they were diagnosed in 148 cases (70.1%).

These included systemic lupus erythematosus (SLE) 71 (33.6%), rheumatoid arthritis 18 (8.5%), others 26 (12.3%), and undiagnosed 33 (15.6%).

Other autoimmune disorders followed with 34 (16.1%).

There were also 23 (10.9%) cases with recurrent abortion and 6 (2.8%)with miscellaneous illnesses.

The different ANA patterns on UFA were: homogeneous 107 (50.7%), speckled 68 (32.2%), nuclear 18 (8.5%), peripheral 7 (3.3%), centromere 1 (0.5%), and mixed 10 (4.7%).

A highly significant association was detected between the peripheral ANA pattern and SLE cases (P<0.01).

Conclusion: Autoimmune disorders, particularly rheumatological, were the commonest diseases associated with positive ANA test.

The predominant ANA pattern was the homogeneous, followed by the speckled which is compatible with reports in the literarture.

ANA staining pattern have limited value in the clinical assessment of autoimmune diseases; however, ANA has very high sensitivity for SLE especially in cases with peripheral ANA pattern.