Skip to main content

Table 1 ANA-reflex test procedure with titres ≥1:160 and typical patterns

From: The ANA-reflex test as a model for improving clinical appropriateness in autoimmune diagnostics

ANA-IIF pattern on HEp-2 cells

Reflex test(s)

Nuclear homogeneous ≥1:160

Antibodies to intracellular specific antigens (ENA) and to dsDNA/nucleosomes

Nuclear speckled ≥1:160

Anti-dsDNA and antibodies to intracellular specific antigens (ENA), possibly including anti-RNA polymerase III

Nuclear Scl70-like ≥1:160

Antibodies to intracellular specific antigens (ENA) (possibly including anti-PM/Scl)

Cytoplasmic speckled ≥1:160

Antibodies to intracellular specific antigens (ENA), including anti-tRNA synthetases and anti-P ribosomal

Pleomorphic PCNA-like (any titre)

Anti-PCNA

Centromere

No confirmation necessary if high titres. Execute specific test for anti-CENP B only in dubious cases (low titre or centromeric pattern not clearly recognizable)

  1. ENA includes SS-A/Ro52 and Ro60, SS-B/La, Sm, RNP, Jo-1, and Scl70