Related Experiment Video
Updated: May 23, 2025
10:05
Simultaneous Distinction of Monospecific and Mixed DFS70 Patterns During ANA Screening with a Novel HEp-2 ELITE/DFS70 Knockout Substrate
Published on: January 17, 2018
35.5K
International Consensus on ANA Patterns (ICAP) Classification Tree Revisited: A Single Centre Report on Four Nuclear
Aanjik Ranjan1, Shamshad Ahmad2, Sushil Kumar3
1AIIMS Patna.
EJIFCC
|March 10, 2025
Summary
Identifying challenging antinuclear antibody (ANA) patterns like Dense Fine Speckled 70 (DFS70) requires expertise due to overlapping features. This study highlights the difficulties in distinguishing homogenous, speckled, DFS70, and quasi-homogenous patterns for accurate autoantibody detection.
Area of Science:
- Immunology
- Clinical Chemistry
- Medical Diagnostics
Background:
- The International Consensus on ANA પરીक्षण (ICAP) classifies antinuclear antibody (ANA) patterns (AC-0 to AC-29), with some requiring expert identification due to overlapping features.
- Certain patterns, like Quasihomogenous, are described by the Bio-systems Clinical Application (BCA) but not fully addressed by ICAP, leading to diagnostic ambiguity.
- This study focuses on four nuclear patterns with overlapping characteristics: Homogenous, Speckled, Dense Fine Speckled 70 (DFS70), and Quasihomogenous, to analyze identification challenges.
Purpose of the Study:
- To investigate the challenges in identifying and distinguishing between Homogenous, Speckled, Dense Fine Speckled 70 (DFS70), and Quasihomogenous ANA patterns.
- To assess the clinical significance and diagnostic implications of these overlapping ANA patterns.
Main Methods:
- Analysis of 388 samples positive for the four nuclear patterns via indirect immunofluorescence (IIF) using HEp-2 cells.
- Line immunoassay (LIA) performed on 103 samples to correlate ANA patterns with specific autoantibodies detected.
Main Results:
- The Dense Fine Speckled 70 (DFS70) pattern, often combined with other autoantibodies, presents identification difficulties using IIF.
- A homogenous pattern was incorrectly associated with AC-29 (anti-topoisomerase, anti-Scl 70), indicating potential misidentification issues.
- Mixed homogenous and speckled patterns correlated with Sm and U1snRNP antibodies.
Conclusions:
- The DFS70 pattern, exhibiting features of both homogenous and speckled patterns, necessitates expert interpretation.
- The AC-29 pattern, an overlap of five components, requires increased awareness due to its identification challenges and expert reporting status.
- The Quasihomogenous pattern (mixed homogenous and speckled) identified by BCA needs to be formally addressed within the ICAP classification system.
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