Figure 115

Patterns of antinuclear antibody (ANA) staining. The ANA test is carried out by incubation of the serum with either preparations of cultured cells (eg, human cervical carcinoma cells [HeLa cells]) or sections of normal tissue (mostly liver). Antibodies bound to the nucleus are detected by a fluorescinated antihuman immunoglobulin antibody that can reveal four distinctive staining patterns: A, homogeneous; B, rim or peripheral;

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FIGURE 11-5 (Continued)

C, speckled; and D, nucleolar. Although not conclusive, these patterns can give an indication about the autoantibody specificity causing the nuclear staining. The homogeneous and peripheral patterns mainly are caused by autoantibodies directed against the nucle-osome (histone-DNA complex) or double-stranded DNA. The speckled pattern can be observed in antibodies against the nuclear proteins Sm, ribonucleoprotein, Sjogren's syn-drome-A [SS-A] (Ro), SS-B (La), Jo-1, topoi-somerase I, and anticentromere antibodies. The nucleolar staining is associated with antibodies against nucleolus-specific RNA, as seen in certain limited forms of scleroderma. (From Maddison [2]; with permission.)

Nucleolar Pattern Nuclear
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