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| Previous Nomenclature | Diffuse |
| Description | Homogeneous fluorescence dispersed throughout the nucleoplasm. The nucleoli may or may not be stained depending on the cell substrate. In mitotic cells (metaphase, anaphase, and telophase) the chromatin mass is intensely stained in a homogeneous fashion. |
| Antigen Association | dsDNA, nucleosomes, histones |
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Clinical Relevance
First level information About Clinical Relevance & List of Abbreviations |
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▶ Found in patients with systemic lupus erythematosus (SLE), drug-induced lupus (DIL), chronic autoimmune hepatitis (AIH), juvenile idiopathic arthritis (JIA) ▶ If SLE is clinically suspected, it is recommended to perform a follow-up test for dsDNA antibodies, alone or in combination with antibodies to dsDNA/histone complexes (nucleosomes/chromatin); dsDNA antibodies are included in the classification criteria for SLE [1-3] ▶ If DIL is suspected, follow-up testing for histone antibodies alone or in combination with antibodies to dsDNA/histone complexes (nucleosomes/chromatin) is suggested [4] ▶ If chronic AIH or JIA is suspected, follow-up testing is not recommended because the respective autoantigens associated with the AC-1 pattern are not completely defined Although autoantibodies to Topoisomerase I (formerly Scl-70) may be reported as nuclear homogeneous, they typically reveal a composite AC-29 HEp-2 IFA pattern; as such, clinical suspicion of systemic sclerosis may warrant follow-up testing for reactivity to this antigen [5, 6] Although AC-1 is the most prevalent pattern in chronic AIH, other HEp-2 IFA patterns may occur, but the autoantigens associated with these patterns are not completely defined [7] |
| Second level information |
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None |
| References |
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1. Conrad K, Schössler W, Hiepe F, Fritzler MJ. Autoantibodies in systemic autoimmune diseases. A diagnostic reference. third ed, 2015 2. Petri M, Orbai AM, Alarcon GS, Gordon C, Merrill JT, Fortin PR, Bruce IN, Isenberg D, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64:2677-86 3. Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, Smolen JS, Wofsy D, et al. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheumatol. 2019;71:1400-12 4. Lee AYS. Clinical use of anti-histone antibodies in idiopathic and drug-induced lupus. Immunol Med. 2022;45:180-5 5. Andrade LEC, Klotz W, Herold M, Conrad K, Ronnelid J, Fritzler MJ, von Muhlen CA, Satoh M, et al. International consensus on antinuclear antibody patterns: definition of the AC-29 pattern associated with antibodies to DNA topoisomerase I. Clin Chem Lab Med. 2018;56:1783-8 6. Dellavance A, Gallindo C, Soares MG, da Silva NP, Mortara RA, Andrade LE. Redefining the Scl-70 indirect immunofluorescence pattern: autoantibodies to DNA topoisomerase I yield a specific compound immunofluorescence pattern. Rheumatology (Oxford). 2009;48:632-7 7. EASL Clinical Practice Guidelines on the management of autoimmune hepatitis. J Hepatol. 2025;83:453-501 |
| FAQ |
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How best to recognize the metaphase plate? Low titer anti-dsDNA serum negative by HEp-2 IFA? Question: Can I have a negative HEp-2 IFA result in a sample with positive Crithidia assay at 1/20? The negative HEp-2 IFA was confirmed with slides from different commercial brands. |
