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19.53%), cytoplasmic (n=78. 1.85%) and mitotic (n=80. 1.90%) were identified while mixed patterns constituted 9.70% (n=408). The most common ANA pattern was fine speckled (AC 4) with prevalence of 3.14% (n=132) whereas the rarest pattern was cytoplasmic fibrillar filamentous (AC 16) with prevalence of 0.02% (n=1).
The Euroimmun ANA Profile 1 is a semi-automated Immunoblot test for antibodies to12 ANA-related extractable nuclear antigens (ENAs). Traditional ENA profiles use a screening pool of 6 ENAs, with positive screening results followed by EIA testing for specific antibody to Sm, RNP, SS-A, SS-B, Scl-70, and Jo-1.
Because more than 30% of normal individuals have been found to have low ANA titers,5 the patients with negative or positive results at a titer of 1:40 were excluded. In our laboratory, an ANA titer of 1:640 is defined as a high titer because of a 0.5% prevalence of positives in normal individuals.
The ANA test is used specifically for the diagnosis of systemic lupus erythematosis (SLE). A positive ANA titer ( 1:80) with the associated clinical signs (e.g. skin disease, polyarthritis) and laboratory findings (e.g. proteinuria, thrombocytopenia) is diagnostic for SLE.
These patterns were recently defined by the International Consensus on ANA Patterns (ICAP) (2). Anti-nucleolar autoantibodies (ANoA) can be homogeneous (AC-8), clumpy (AC-9), or punctate (AC-10).
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The cytoplasmic reticular pattern (AC-21) is strongly associated with anti-mitochondria antibodies, which represent robust evidence for PBC and are taken as evidence against the diagnosis of AIH.
The initial requirement of the criteria for lupus diagnosis is a positive ANA test with a titer of at least 80.
Due to its high sensitivity and specificity, the indirect immunofluorescence test (IIFT) using human epithelial cells (HEp-2) and primate liver is the gold standard for the detection of anti-nuclear autoantibodies (ANA).