Antinuclear Antibodies (ANA Testing)

Question 1

What ANA pattern is associated with Anti-Histone antibody?

Answer 1

Homogenous (diffuse)

Question 2

What ANA pattern is associated with Anti-ds DNA (double stranded DNA)?

Answer 2

Peripheral (Rim)

Question 3

What ANA pattern is associated with Anti-RNA and Anti-ENA (extractable nuclear antigens)?

Answer 3

Speckled

Question 4

What ANA pattern is associated with Anti-nucleolar RNA?

Answer 4

Nucleolar

Question 5

What ANA pattern is associated with SLE?

Answer 5

Homogenous (main),
Peripheral/rim
Speckled

Question 6

What ANA pattern is associated with Scleroderma (PSS)?

Answer 6

Speckled & Nucleolar

Question 7

What ANA pattern is associated with rheumatoid arthritis (RA)?

Answer 7

Speckled

Question 8

What ANA pattern is associated with MCTD?

Answer 8

Speckled

Question 9

What ANA pattern is associated with Scleroderma?

Answer 9

Nucleolar and Speckled

Question 10

What ANA pattern is associated with Sjogren’s?

Answer 10

Nucleolar

Question 11

What antibody/antibodies is/are associated with SLE?

Answer 11

Anti-histone
Anti-ds DNA
Anti-RNA and Anti-ENA

Question 12

What antibody/antibodies are associated with Scleroderma (PSS - Progressive Systemic Sclerosis)?

Answer 12

Anti-RNA and Anti-ENA

Nucleolar

Question 13

What antibody/antibodies are associated with RA?

Answer 13

Anti-RNA and Anti-ENA

Question 14

What antibody/antibodies are associated with MCTD?

Answer 14

Anti-RNA and Anti-ENA

Question 15

What antibody/antibodies are associated with Sjogren’s syndrome?

Answer 15

Nucleolar

Question 16

What disease(s) is associated with a homogenous/diffuse ANA pattern?

Answer 16

usually SLE

Question 17

What disease(s) is associated with a peripheral/rim ANA pattern?

Answer 17

SLE

Question 18

What disease(s) is associated with a speckled ANA pattern?

Answer 18

SLE, scleroderma (PSS), RA and MCTD

Question 19

What disease(s) is associated with a nucleolar ANA pattern?

Answer 19

Scleroderma

Sjogren’s syndrome

Question 20

How does the speckled ANA pattern differ from the centromere ANA pattern?

Answer 20

Speckled ANA pattern –> granular/speckled staining in the nucleus of the interphase cells
Absence of staining in the chromosomal area of the metaphase mitotic cells.

Centromere ANA pattern –> granular/speckled staining in the nucleus of the interphase cells AND metaphase mitotic cells.

Question 21

What extractable nuclear antibody is highly specific for SLE but occurs in only 29-30% of cases?

Answer 21

Smith (Sm) antibody

Question 22

What % of patients with SLE will test positive for ANAs?

Answer 22

95%

Question 23

What type of antibodies are found in primary biliary cirrhosis?

Answer 23

Anti-mitochondrial antibodies

Question 24

What ANA pattern occurs to any extractable nuclear antigen devoid of histones or DNA?

Answer 24

Speckled

Question 25

Which method remains the “gold standard” for ANA detection?

Answer 25

Slide-based immunofluorescence assay (IF)

Question 26

How would you determine if a homogenous or peripheral ANA pattern was due to Anti-ds DNA or Anti-DNP (Le Factor?)

Answer 26

Request Crithidia

Crithidia + = Anti dsDNA –> SLE
Crithidia - = Anti-DNP (Le Factor)

Question 27

A Negative ANA pattern would rule out what?

Answer 27

SLE

Question 28

What antibody is associated with Centromere (kinetechore) ANA pattern?

Answer 28

Anti-centromere (CREST)