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ANA Patterns

Nuclear

Cytoplasmic

Mitotic

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 AC-2 - Nuclear dense fine speckled 

Previous Nomenclature None

Description Speckled pattern distributed throughout the interphase nucleus with characteristic heterogeneity in the size,
brightness and distribution of the speckles. Throughout the interphase nucleus, there are some denser and looser
areas of speckles (very characteristic feature). The metaphase plate depicts strong speckled pattern with some
coarse speckles standing out.

Antigen Association DFS70/LEDGF

Clinical Relevance
First level information
$ About Clinical Relevance & List of Abbreviations

Commonly found as high titer HEp-2 IIFA-positive in apparently healthy individuals or in patients who do not have a systemic autoimmune
rheumatic disease (SARD) (9)

The negative association with SARD is only valid if the autoreactivity is confirmed as being directed to DFS70 (also known as LEDGF/p75) and
if no other common ENA is recognized (20, 21)

Both in apparently healthy individuals as well as patients who do not have a SARD the AC-2 pattern may be caused by autoantibodies to
other antigens than DFS70 (22)

Note: Confirmatory assays for anti-DFS70 antibodies may be available only in specialty clinical laboratories.

First level information references

9. Mariz HA, Sato EI, Barbosa SH, et al. Pattern on the antinuclear antibody-HEp-2 test is a critical parameter for discriminating antinuclear
antibody-positive healthy individuals and patients with autoimmune rheumatic diseases. Arthritis & Rheumatism 2011;63:191–200.

20. Watanabe A, Kodera M, Sugiura K, et al. Anti-DFS70 antibodies in 597 healthy hospital workers. Arthritis Rheum 2004;50:892–900.

21. Mahler M, Parker T, Peebles CL, et al. Anti-DFS70/LEDGF antibodies are more prevalent in healthy individuals compared to patients with
systemic autoimmune rheumatic diseases. J Rheumatol 2012;39:2104–10.

22. Ochs RL, Mahler M, Basu A, et al. The significance of autoantibodies to DFS70/LEDGFp75 in health and disease: integrating basic science
with clinical understanding. Clin Exp Med 2016;16:273–93.

Second level information

None

Second level information references

None

FAQ

The pseudo-DFS pattern? Some samples yield a nuclear speckled pattern with similar staining at the mitotic chromatin (metaphase and
anaphase), very similar to AC-2 (nuclear dense fine speckled pattern), but do not yield a positive result in immunoassays specific for anti-
+
DFS70 antibodies. How should I report such pattern since it is not exactly the AC-2 pattern and there is no anti-DFS70 reactivity? Is this
pattern defined by ICAP?

Fine Art with AC-29. Is it critical that all five elements of the subcellular domains associated with the AC-29 pattern be evaluated in order to
+
correctly classify an individual serum as AC-29? In other words, can it be classified as AC-29 with staining of only some of the five elements?

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