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ANA Assay Flow Chart

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|Antibody |HEp-2 pattern |Clinical associations |

|U1RNP |Coarse speckles across all nucleoplasm. |MCTD (100% if Sm/dsDNA –ve), SLE (13-32%) with Raynaud’s, vasculitic skin and mucosal manifestations, SSc (10%) |

| | |with pulmonary fibrosis and joint involvement. |

|Centromere B |Discrete coarse speckles scattered in interphase cells and aligned at the chromatin |Limited SSc (CREST*) (57-82%), Diffuse SSc (2-12%), PBC (10-30%). |

| |mass on mitotic cells. | |

| | |* CREST = Calcinosis, Raynaud’s, Oesophageal dysmotility, Sclerodactyly, Telangectasia |

|dsDNA |Homogeneous and regular fluorescence across all nucleoplasm |SLE: specificity 95%, sensitivity >70% in active SLE (levels fluctuate with disease activity). >95% if active SLE|

| | |with renal involvement, 50-70% if active SLE without renal involvement, ................
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