Which ANA pattern is commonly associated with systemic lupus erythematosus?

• A. Homogeneous or speckled patterns
• B. Nucleolar pattern
• C. Centromere pattern
• D. Cytoplasmic pattern

Answer: (A)

In ANA testing using indirect immunofluorescence on HEp-2 cells, systemic lupus erythematosus most often shows a homogeneous staining pattern, and a speckled pattern is also common. The homogeneous pattern reflects antibodies against double-stranded DNA and histones, which are closely linked to SLE, while the speckled pattern arises from antibodies against a variety of nuclear antigens such as Sm and RNP that are frequently seen in SLE as well. Other patterns point to different diseases: centromere pattern is typical of limited systemic sclerosis (CREST), nucleolar pattern is more associated with systemic sclerosis, and cytoplasmic pattern indicates antibodies to cytoplasmic antigens (for example, anti–Jo-1 in inflammatory myopathies). Therefore, the pattern most commonly associated with SLE is homogeneous or speckled.