Disease distributions in patients with multiple patterns of nuclear staining detected by FANA (immunofluorescent antinuclear antibody) tests.

The present study examines disease distributions in patients with multiple nuclear immunofluorescent staining patterns detected by FANA testing. Among 4003 consecutive patient sera examined, we found that 813 yielded conventional well-defined single staining patterns, while 46 produced multiple pattern combinations. Homogeneous plus nucleolar was the most prevalent combination, and 5 other combinations were identified. Multiple FANA patterns occurred independently of FANA titers and antibodies to dsDNA and Sm. Compared to control patients with single FANA patterns, patients with multiple patterns were found to have an increased frequency of SLE and diseases of the scleroderma spectrum (DDS) while rheumatoid arthritis (RA) and non-immunologic disease were reduced in frequency. These specific correlations indicate that recognition of multiple FANA patterns adds useful diagnostic information to existing antinuclear antibody testing procedures.