The antinuclear antibody dense fine speckled pattern and possible clinical associations: An indication of a proinflammatory microenvironment

2021 ◽  
Vol 488 ◽  
pp. 112904
Author(s):  
Mia C. Lundgren ◽  
Smarika Sapkota ◽  
Daniel J. Peterson ◽  
John T. Crosson
Keyword(s):  
Antinuclear Antibody ◽  
Speckled Pattern ◽  
Clinical Associations

Rowell’s syndrome: a rare but distinct entity in rheumatology

2020 ◽  
Vol 13 (9) ◽  
pp. e235173
Author(s):  
Atanu Chandra ◽  
Swarup Kanta Saha ◽  
Aritra Kumar Ray ◽  
Parthasarathi Karmakar
Keyword(s):  
Lupus Erythematosus ◽  
Antinuclear Antibody ◽  
Hard Palate ◽  
Clinical Presentation ◽  
Skin Lesions ◽  
Crust Formation ◽  
Distinct Entity ◽  
Speckled Pattern ◽  
Positive Antinuclear Antibody ◽  
Rowell’S Syndrome

Rowell’s syndrome is a rare disorder characterised by an association of lupus erythematosus with erythema multiforme (EM)-like skin lesions. EM as the initial clinical presentation of systemic lupus erythematosus is also atypical and even rarer. We report the case of an 18-year-old girl admitted to our hospital with fever and polyarthralgia along with multiple discrete ill-defined target lesions with crust formation over forehead, cheek, external ears, scalp, upper chest and back (predominantly over sun-exposed areas) with ulceration over hard palate. Investigations revealed pancytopaenia, a positive rheumatoid factor, positive antinuclear antibody with a speckled pattern, anti-Smith antibody and strongly positive anti-Ro. Patient was diagnosed with Rowell’s syndrome as per clinical and laboratory features. Majority of skin lesions including oral ulcerations subsided gradually after treatment with steroids and hydroxychloroquine.

scholarly journals Association of Immunofluorescence pattern of Antinuclear Antibody with Specific Autoantibodies in the Bangladeshi Population

2015 ◽  
Vol 40 (2) ◽  
pp. 74-78 ◽  
Author(s):  
S Sharmin ◽  
S Ahmed ◽  
A Abu Saleh ◽  
F Rahman ◽  
MR Choudhury ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Lupus Erythematosus ◽  
Antinuclear Antibody ◽  
Research Work ◽  
Connective Tissue Disorder ◽  
Nuclear Antigen ◽  
Dot Blot ◽  
Serum Samples ◽  
Speckled Pattern ◽  
Extractable Nuclear Antigen

Antinuclear antibody (ANA) is useful in the diagnosis of connective tissue disorder (CTD). Association of specific autoantibodies with the immunofluorescence pattern of ANA in CTD, noted in western literature has been considered as reference in all over the world. However, in Bangladesh no such research work or data correlating the autoantibodies and their ANA patterns is found. Objective of the study was to identify an association between immunofluorescence patterns of antinuclear antibody on HEp-2 cell and more specific antinuclear reactivities (e.g. anti-dsDNA and anti-extractable nuclear antigen) in the serum samples of CTD patients. Serum samples of 152 CTD patients (Systemic lupus erythematosus, Rhumatoid arthritis, Sjogren´s syndrome, Systemic sclerosis, Polymyositis, Mixed connective tissue disease) were diagnosed clinically, attending at Bangabandhu Sheikh Mujib Medical University (BSMMU) during the study period of January, 2010 to December, 2010. Samples were subjected for ANA testing by Indirect Immunofluorescence (IIF) on HEp-2 cell (ALPHADIA) in dilution of 1:40, anti-dsDNA by ELISA and anti- extractable nuclear antigen (anti-ENA) by Dot Immunoblot. Dot blot strips were tested for anti-Sm, anti-RNP, anti-SSA/Ro, anti-SSB/La, anti-Scl-70 and anti-Jo-1. Out of 152 patients 110 (72.3%) cases were ANA positive by IIF on HEp-2 cell. ANA positive sera exhibited four fluorescence patterns such as speckled (50.8%), peripheral (21.6%) ,homogenous (18.1%) and nucleolar pattern (9%). Peripheral pattern and homogenous pattern was predominantly associated with anti-dsDNA (p<0.05). Speckled pattern was significantly associated with anti-ENA (p<0.05).The most commonly identified antinuclear autoreactivity was directed towards anti-RNP (25.7%) then anti-Scl-70 (20%), anti-SSA (14.2%) and anti-SSB (5.7%). Multiple anti-ENA reactivities were identified in 34.28% cases. Peripheral and homogenous pattern is strongly associated with anti-dsDNA and speckled pattern may predict anti-ENA (specially ribonucleoprotiens). As a definite correlation between the ANA patterns and the group of antibodies was detected by dot immunoblot, one could predict presence of certain specific auto antibodies for a particular ANA pattern identified. This may restrict on the cost of laboratory investigations in a developing country like Bangladesh. Thus, ANA-IIF method may reduce the expense of detailed immunological work-up with minimal loss in diagnostic accuracy.Bangladesh Med Res Counc Bull 2014; 40 (2): 74-78

scholarly journals Nailfold Capillaroscopy Characteristics of Antisynthetase Syndrome and Possible Clinical Associations: Results of a Multicenter International Study

2018 ◽  
Vol 46 (3) ◽  
pp. 279-284 ◽  
Author(s):  
Marco Sebastiani ◽  
Konstantinos Triantafyllias ◽  
Andreina Manfredi ◽  
Miguel Angel González-Gay ◽  
Natalia Palmou-Fontana ◽  
...  
Keyword(s):  
Antinuclear Antibody ◽  
Disease Duration ◽  
International Study ◽  
Control Group ◽  
Antisynthetase Syndrome ◽  
Nailfold Videocapillaroscopy ◽  
Raynaud Phenomenon ◽  
Historical Cohort ◽  
Male Ratio ◽  
Clinical Associations

Objective.To describe nailfold videocapillaroscopy (NVC) features of patients with antisynthetase syndrome (AS) and to investigate possible correlations with clinical and serological features of the disease.Methods.We retrospectively analyzed NVC images of 190 patients with AS [females/males 3.63, mean age 49.7 ± 12.8 yrs, median disease duration 53.7 mos (interquartile range 82), 133 anti-Jo1 and 57 non–anti-Jo1-positive patients]. For each patient, we examined number of capillaries, giant capillaries, microhemorrhages, avascular areas, ramified capillaries, and the presence of systemic sclerosis (SSc)-like pattern. Finally, we correlated NVC features with clinical and serological findings of patients with AS. Concomitantly, a historical cohort of 75 patients with antinuclear antibody–negative primary Raynaud phenomenon (RP) and longterm followup was used as a control group (female/male ratio 4.13/1, mean age 53.9 ± 17.6 yrs) for NVC measures.Results.NVC abnormalities were observed in 62.1% of AS patients compared with 29.3% of primary RP group (p < 0.001). An SSc-like pattern was detected in 67 patients (35.3%) and it was associated with anti-Jo1 antibodies (p = 0.002) and also with a longer disease duration (p = 0.004). Interestingly, there was no significant correlation between the presence of SSc-like pattern and RP, and only 47% of patients with SSc-like pattern had RP.Conclusion.NVC abnormalities are commonly observed in AS, independently from the occurrence of RP. The presence of an SSc-like pattern could allow identification of a more defined AS subtype, and prospective studies could confirm the association with clinical and serological features of AS.

scholarly journals Neutrophil nuclear patterns to distinguish between pathological and non-pathological autoantibodies detected on HEp-2 cells

2020 ◽  
Author(s):  
Dong Il Won ◽  
Jihea Park ◽  
Beom Soo Kim ◽  
Chae Eun Kim ◽  
Heon Sik Yoon ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Antinuclear Antibody ◽  
Cell Nuclei ◽  
Systemic Lupus ◽  
Speckled Pattern ◽  
Autoimmune Rheumatic Disease ◽  
Diffuse Systemic Sclerosis ◽  
Systemic Autoimmune Rheumatic Disease

AbstractBackgroundAntinuclear antibody (ANA) testing is used to diagnose systemic autoimmune rheumatic disease (SARD). Autoantibodies (Abs) associated with the “homogeneous-like” pattern on ANA HEp-2 cell nuclei can be classified as pathological (e.g., anti-dsDNA, anti-nucleosome, anti-histone, anti-Scl-70 Abs) or non-pathological (e.g., anti-DFS70 Abs).MethodsAnti-neutrophil cytoplasmic anti-antibody (ANCA) testing was used to classify individuals who presented with a homogeneous-like pattern on ANA testing. Enrolled subjects included (1) young individuals with a dense fine speckled pattern on ANA testing (young non-SARD group, n = 62) and patients with (2) systemic lupus erythematosus (SLE) with anti-dsDNA Abs (SLE group, n = 33), (3) rheumatoid arthritis (RA) with anti-nucleosome, anti-histone Abs, and others (RA group, n = 45), and (4) diffuse systemic sclerosis (SSc) with Scl-70 Abs (diffuse SSc group, n = 11).ResultsNegative rates (95% confidence interval) of neutrophil nuclear patterns on ANCA testing were: 96.8% (88.8%–99.6%) of the young non-SARD group, 3.0% (0.1 %–15.8%) of the SLE group, 4.4% (0.5%–15.2%) of the RA group, and 54.5% (23.4%–83.3%) of the diffuse SSc group. The negative rate of the non-SARD group was significantly higher than those of the SARD group (all P < 0.05).ConclusionsANCA testing helps to identify individuals with non-pathological anti-DFS70 Abs who present with homogeneous-like patterns in HEp-2 cell nuclei on ANA testing.

scholarly journals Immunofluorescence pattern of antinuclear antibody and its association with autoantibody profile in systemic lupus erythematosus

2016 ◽  
Vol 6 (2) ◽  
pp. 141
Author(s):  
Sadia Sharmin ◽  
Sharmeen Ahmed ◽  
Humayun Sattar ◽  
Md. Ruhul Amin Miah ◽  
Minhaz Rahim Chowdhury ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Antinuclear Antibody ◽  
Research Work ◽  
Nuclear Antigen ◽  
Dot Blot ◽  
Systemic Lupus ◽  
Serum Samples ◽  
Speckled Pattern ◽  
Extractable Nuclear Antigen

<p><strong>Background:</strong> Antinuclear antibody (ANA) is useful in the diagnosis of systemic lupus erythematosus (SLE). Association of specific autoantibodies with the immunofluorescence pattern of ANA in SLE as noted in Western literature has been taken as reference in all over the world. However, in Bangladesh such research work or data correlating the autoantibodies and their ANA patterns is inadequate. <strong></strong></p><p><strong>Objective:</strong> To identify an association between immunofluorescence patterns of antinuclear antibody on HEp-2 cell and more specific antinuclear reactivities (e.g. anti-dsDNA and anti-extractable nuclear antigen) in the serum samples of SLE patients.</p><p><strong>Methods:</strong> Serum samples of 37 SLE patients who were diagnosed by ARA (American Rheumatism Association) classification criteria and laboratory tests, attending at lupus clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) during the study period of six months were subjected for ANA testing by Indirect Imrnunofluorescence (IIF) on HEp-2 cell, anti-dsDNA by ELISA and anti- extractable nuclear antigen (anti-ENA) by Dot Immunoblot. Dot blot strips were tested for anti-Sm, anti-RNP, anti-SSA/Ro, and anti-SSB/La. <strong></strong></p><p><strong>Results:</strong> Out of 37 SLE patients 32 (86.5%) cases were ANA positive by IIF on HEp-2 cell. ANA positive sera exhibited three fluorescence patterns such as speckled (43.7%), peripheral (34.3%) and homogenous pattern (21.8%). Peripheral pattern (100%) was strongly associated with anti-dsDNA (p&lt;0.05) and homogenous pattern (85.7%) was also predominantly associated with anti-dsDNA (p&lt;0.05). Speckled pattern (85.6%) was significantly associated with anti-ENA (p&lt;0.05). Anti-dsDNA was positive in 75% of SLE cases and majority (45.8%) of which showed peripheral pattern whereas anti-ENA was positive in 48.6% cases and majority (70.5%) of which showed speckled pattern. The most commonly identified antinuclear autoreactivity was directed towards anti-RNP (22.2%) then anti-Sm (16.6%), anti-SSA (16.6%) and anti-SSB (11.1 %). Multiple anti-ENA reactivities were identified in 33.3% cases. <strong></strong></p><p><strong>Conclusion:</strong> Peripheral and homogenous pattern is strongly associated with anti-dsDNA therefore may be predicted that patients have active SLE and speckled pattern may predict anti-ENA (specially ribonucleoprotiens). Thus, ANA-IIF method may suffice and probably reduce the expense of detailed immunological work-up with minimal loss in diagnostic accuracy.</p>

scholarly journals Clinical significance of anti-DFS70 antibody in antinuclear antibody-positive samples with a dense fine speckled pattern

2019 ◽  
Vol 43 (3) ◽  
pp. 149-155 ◽  
Author(s):  
Sun Hoe Koo ◽  
Jimyung Kim ◽  
Seon Young Kim ◽  
Gye Cheol Kwon
Keyword(s):  
Rheumatic Disease ◽  
Clinical Significance ◽  
Rheumatic Diseases ◽  
Antinuclear Antibody ◽  
Antinuclear Antibodies ◽  
Diagnostic Algorithm ◽  
The Other ◽  
Disease Group ◽  
Speckled Pattern ◽  
Potential Use

Abstract Background When the dense fine speckled (DFS) pattern-antinuclear antibodies (ANA) are detected in the indirect immunofluorescence (IIF) assay, the presence of anti-dense fine speckles 70 (DFS70) antibodies has been suggested to facilitate the exclusion of ANA-associated rheumatic diseases (AARD). We evaluated the potential use of anti-DFS70 antibodies for verifying AARD in patients with a positive ANA result of the DFS pattern. Methods A total of 5509 patients who were requested ANA testing were included. The DFS pattern was confirmed using two IIF assays. Semiquantitative DFS70 ELISA (Euroimmun, Germany) was examined in samples with the DFS pattern. Results Among 639 ANA-positive patients, 19.6% displayed the DFS pattern. And 17.6% of patients with the DFS pattern were diagnosed with AARD. The low titer of 1:80 was more prevalent in the non-AARD group than in the AARD group (64.1% vs. 4.5%, p < 0.0001). Anti-DFS70 antibodies were positive in 60.0% of patients with the DFS pattern. The frequency of anti-DFS70 positivity was higher in the non-rheumatic disease (NRD) group (74.2%) than in the other rheumatic disease group (43.2%, p = 0.003) and the AARD group (45.5%, p = 0.019). Conclusions The DFS pattern is present in both AARD and non-AARD cases. In the DFS pattern, a low titer of 1:80 and isolated anti-DFS70 antibodies without AARD-associated antibodies represent a low likelihood of AARD. The presence of anti-DFS70 antibodies cannot exclude AARD and should be analyzed in combination with AARD-associated antibodies in the diagnostic algorithm.

scholarly journals Antinuclear Antibodies and Clinical Associations in a British Cohort with Limited Cutaneous Systemic Sclerosis

2011 ◽  
Vol 38 (4) ◽  
pp. 702-705 ◽  
Author(s):  
ANGELA E. GLIDDON ◽  
CAROLINE J. DORÉ ◽  
JULIET DUNPHY ◽  
ZOË BETTERIDGE ◽  
NEIL J. McHUGH ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Antinuclear Antibody ◽  
Clinical Characteristics ◽  
Antinuclear Antibodies ◽  
Prognostic Significance ◽  
Selective Reduction ◽  
Anticentromere Antibody ◽  
Specific Antibodies ◽  
Clinical Associations ◽  
Disease Specific

Objective.To assess the prevalence of disease-specific autoantibodies in patients with limited cutaneous systemic sclerosis (lcSSc).Methods.Sera from 180 patients with lcSSc were analyzed for antinuclear antibody (ANA). Clinical characteristics were compared in the presence or absence of specific autoantibodies.Results.SSc-specific antibodies were detected in 135 patients (75%). Associations were found between anticentromere antibody and age at lcSSc diagnosis, telangiectasia, reduced creatinine clearance, and selective reduction in DLCO, and between antitopoisomerase-I and pulmonary fibrosis.Conclusion.The majority of patients with lcSSc belong to distinctive serologic subsets, potentially with prognostic significance.

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