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| Previous Nomenclature | AC-4a, nuclear fine speckled |
| Description | Fine tiny discrete speckles are distributed throughout the nucleoplasm representing the characteristic myriad discrete speckled nuclear pattern. The nucleoli are not stained. In mitotic cells (metaphase, anaphase, and telophase) the chromatin mass is not stained which is in contrast to the surrounding cytoplasm. |
| Antigen Association | The AC-31 pattern is strongly associated with anti-TROVE2/Ro60 (formerly known as SS-A/Ro60 [1]) antibodies[2-4]. In contrast, the plain fine speckled pattern (AC-4) is much less frequently associated with anti-TROVE2/Ro60. The coexistence of additional antinuclear antibodies in anti-TROVE2/Ro60 positive samples frequently obscures the unambiguous features of the AC-31 pattern; therefore, such anti-TROVE2/Ro60 positive samples may not show the expected AC-31 pattern [4]. |
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Clinical Relevance
First level information About Clinical Relevance & List of Abbreviations |
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▶ Because of the strong association with anti-TROVE2/Ro60 antibodies, the AC-31 pattern is frequently seen in patients with systemic lupus erythematosus (SLE) and Sjögren’s disease (SjD). It is not commonly observed in healthy individuals, as opposed to the AC-4 plain fine speckled nuclear pattern that is one of the most frequent HEp-2 IFA patterns in asymptomatic individuals and patients with no systemic autoimmune disease. |
| Second level information |
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None |
| References |
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1. 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. 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. Dellavance A, Alvarenga RR, Rodrigues SH, Barbosa SH, Camilo AC, Shiguedomi HS, Rodrigues SS, Silva CG, et al. Autoantibodies to 60kDa SS-A/Ro yield a specific nuclear myriad discrete fine speckled immunofluorescence pattern. J Immunol Methods. 2013;390:35-40. 4. Rober N, Dellavance A, Ingenito F, Reimer ML, Carballo OG, Conrad K, Chan EKL, Andrade LEC. Strong Association of the Myriad Discrete Speckled Nuclear Pattern With Anti-SS-A/Ro60 Antibodies: Consensus Experience of Four International Expert Centers. Front Immunol. 2021;12:730102. |
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