   |
|
| Previous Nomenclature | chromosome coat protein, dividing cell antigen, mitotic chromosome autoantigen (MCA) |
| Description | Punctate coloration of chromosomes in pro- and metaphase with no staining of interphase cells. |
| Antigen Association | modified histone H3, MCA-1 |
|
Clinical Relevance
First level information About Clinical Relevance & List of Abbreviations |
|
▶ The AC-28 pattern has low positive predictive value for any disease ▶ Found very infrequently in a routine serology diagnostic setting (120) ▶ Antigens recognized include DCA, MCA1, and MCA5; specific immunoassays for these autoantibodies are currently not commercially available (120–122) |
| First level information references |
|
120. Gitlits VM, Macaulay SL, Toh BH, et al. Novel human autoantibodies to phosphoepitopes on mitotic chromosomal autoantigens (MCAs). J Investig Med 2000;48:172-82. 121. Blaschek M, Muller S, Youinou P. Anti-"dividing cell antigen" autoantibody: a novel antinuclear antibody pattern related to histones in systemic lupus erythematosus. J Clin Immunol 1993;13:329-38. 122. Rayzman VM, Sentry JW. MCA1 detection of histone H3 serine 10 phosphorylation, a novel biomarker for determination of mitotic indices. Hum Antibodies 2006;15:71-80. |
| Second level information |
|
▶ Autoantibodies to DCA have been described in patients with SLE (18) ▶ Autoantibodies to MCA1 have been described in patients with carcinoma (19) ▶ Autoantibodies to MCA5 have been described in patients with discoid lupus erythematosus, chronic lymphocytic leukemia, SjS, and polymyalgia rheumatica (20) |
| Second level information references |
|
18. Blaschek M, Muller S, Youinou P. Anti-"dividing cell antigen" autoantibody: a novel antinuclear antibody pattern related to histones in systemic lupus erythematosus. J Clin Immunol 1993;13:329-38. 19. Rayzman VM, Sentry JW. MCA1 detection of histone H3 serine 10 phosphorylation, a novel biomarker for determination of mitotic indices. Hum Antibodies 2006;15:71-80. 20. Gitlits VM, Macaulay SL, Toh BH, et al. Novel human autoantibodies to phosphoepitopes on mitotic chromosomal autoantigens (MCAs). J Investig Med 2000;48:172-82. |
| FAQ |
|
How to deal with just a “nuclear speckled” IFA report? In my practice I have followed patients with ANA findings, with a nuclear speckled pattern (without specifying whether fine/dense/coarse), in patients with very heterogeneous phenotypes, some with a clinical picture that suggests further investigation of systemic autoimmune disease (one patient with proximal muscle weakness and skin thickening) and others who represent only non-specific findings. In such situations, as a precaution, I request more specific autoantibodies. However, this pattern (nuclear speckled pattern) is not described by the "ICAP" and I am in doubt about which antigenic association it represents, even to guide which autoantibody may be present and which ones to look after. How to interpret this pattern? Does the lab describe it when it is not possible to "refine" such a conclusion? Could this be associated with deficiency in the methodology, sample, interpretation? |