Patterns of anti-nuclear antibodies in patients with primary biliary cirrhosis and primary Sjögren syndrome

Abstract

To investigate the anti-nuclear antibody (ANA) patterns in the diagnosis of primary biliary cirrhosis (PBC) and primary Sjögren syndrome (SS). Serum samples from 61 cases of PBC, 28 cases of primary SS, and 11 cases of overlap syndrome of PBC and SS were collected to detect the ANA with indirect immunofluorescence staining, and the difference in ANA patterns was analyzed between the PBC and SS patients. Antinuclear antibodies were detected in 85.2% of the PBC patients, with the following hierarchy of specificities: 37.7% being rim-like, 21.3% being discrete speckled, 18.0% being speckled, 8.2% being multiple nuclear dots, and 4.9% being anti-lamin; 89.3% of the primary SS patients was ANA positive with speckled antibody, only one of them presented discrete speckles (3.6%); and all of the PBC patients overlapped with SS (100%) were positive in ANA, and their contexture of ANAs was similar to those of the PBC patients: 45.5% being rim-like, 18.2% being discrete speckled, 18.2% being speckled, 18.2% being anti-lamin, and 9.1% being multiple nuclear dots. Rim-like pattern and multiple nuclear dots were statistically significant for the diagnosis of PBC, compared with primary SS (chi(2) = 14.236, 3.781, P < 0.01, < 0.05). The ANA patterns of PBC are different from those of primary SS. Among them, rim-like pattern and multiple nuclear dots are highly specific nuclear patterns of PBC and may be useful in diagnosing individuals without anti-mitochondrial antibodies.