Anti-Nuclear Antibodies | Inflammatory Screen - MedSchool
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Anti-Nuclear Antibodies

 
 
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Overview

  • Anti-nuclear antibodies bind to antigens within the nucleus of human cells, including nucleic acid, histone, chromatin and proteins.
  • When present in compatible clinical circumstances, ANAs can be very useful in the diagnosis of certain connective tissue diseases and inflammatory myopathies.

Positive ANA

    • Interpretation

    • The reported titre is the final level of dilution at which the ANA remains positive. the threshold for a 'positive' result is varied but may be e.g. >1:160.
    • Causes of Elevated ANA

    • Rheumatic

    • Systemic lupus erythematosus
    • Scleroderma / systemic sclerosis
    • Polymyositis / dermatomyositis
    • Juvenile idiopathic arthritis
    • Mixed connective tissue disease
    • Sjögren’s syndrome
    • Rheumatoid arthritis
    • Non-Rheumatic

    • Thyroid disease - Hashimoto’s, Grave’s
    • Hepatitis - autoimmune or viral
    • Chronic infection
    • Malignancy

ANA Staining Pattern

  • The morphology of anti-nuclear antibody staining on indirect immunofluorescence may provide a clue as to the type of antibodies present.
    • Interpretation

    • Homogenous - SLE, drug-induced lupus, juvenile idiopathic arthritisAntibodies vs dsDNA, nucleosomes or histones
    • Speckled - SLE, Sjogren's, dermatomyositis, scleroderma, mixed connective tissue diseaseAntibodies vs SSa (Ro), SSb (La), RNP, RNA polymerase III, SCL-70, Mi2, Ku
    • Nucleolar - scleroderma, dermatomyositis / polymyositisAntibodies vs PM-Scl, fibrillarin, Th/To
    • Centromere - limited cutaneous sclerodermaAntibodies vs CENP-B
    • Cytoplasmic - mixed connective tissue disease, anti-synthetase syndromeAntibodies vs Jo1
Last updated on January 20th, 2018
 
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