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| Previous Nomenclature | Pseudo-DFS [1]; Nuclear Speckled with Positive Metaphases; Nuclear Homogeneous Speckled; Nuclear Homo/Speckled. |
| Description | The speckled staining pattern is uniformly distributed throughout the interphase nucleus, exhibiting homogeneity in speckle size, brightness, and distribution. A similar speckled pattern is observed in the metaphase plate. Importantly, a nuclear speckled pattern with the metaphase plate with a homogeneous (hyaline) texture should be classified as a mixed nuclear pattern and not as AC-30 [2, 3]. |
| Antigen Association | AC-30 samples frequently do not exhibit a known autoantibody. However, the AC-30 pattern can also arise from the concurrent presence of multiple clinically relevant autoantibodies, particularly those targeting dsDNA, nucleosomes, Sm, U1-RNP, Scl-70/topo-I, SS-A/Ro60 (formerly known as SS-A/Ro60 [4]), and/or SS-B/La. The coexistence of two or more of these antibodies may interfere with the expression of their individual characteristic patterns, resulting in the AC-30 pattern. In this context, the AC-30 can be considered a specific case of mixed pattern. Additionally, some AC-30 samples contain anti-DFS70 antibodies in combination with other antinuclear antibodies, which can mask the typical anti-DFS70-associated AC-2 pattern. |
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Clinical Relevance
First level information About Clinical Relevance & List of Abbreviations |
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▶ The AC-30 pattern is commonly observed in individuals without any apparent autoimmune disease. However, since it may reflect the combined reactivity of several antinuclear antibodies, the AC-30 pattern can occasionally be seen in patients with systemic autoimmune rheumatic diseases, especially in cases with multiple antinuclear antibodies [2, 5]. |
| Second level information |
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None |
| References |
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1. Infantino M, Bizzaro N, Grossi V, Manfredi M. The long-awaited 'pseudo-DFS pattern'. Expert Rev Clin Immunol. 2019;15:445. 2. Andrade LEC, Klotz W, Herold M, Musset L, Damoiseaux J, Infantino M, Carballo OG, Choi M, et al. Reflecting on a decade of the international consensus on ANA patterns (ICAP): Accomplishments and challenges from the perspective of the 7th ICAP workshop. Autoimmun Rev. 2024;23:103608. 3. de Melo Cruvinel W, Ferreira GG, de Souza LL, da Costa Veloso Neto W, Gomes CM, Francescantonio PLC, Andrade LEC. The spectrum of nuclear patterns with stained metaphase chromosome plate: morphology nuances, immunological associations, and clinical relevance. Clin Chem Lab Med. 2025. 4. Ben-Chetrit E, Fritzler MJ, Andrade LEC, Chan EKL, Choi M, et al. Revised terminology for SS-A/Ro antigens by Delphi consensus. in preparation. 2025. 5. Durmus MA, Komec S. Frequency of the AC-2 pattern's new variant (AC-30) and detection of different immunological relationships. Clin Immunol. 2025;278:110536. |
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