Dual ANA Pattern? Nucleolar and Centromere

[Shelly]

Hi All,

I was just wondering if anyone has ever had a similar experience.  I was diagnosed with Sjogren's last year after my symptoms, a positive ANA and positive SSA.  I recently had some more blood work done, including another ANA.  My ANA for this most recent blood test was positive but showed a dual pattern of Anti-Centromere and Anti-Nucleolar.  I am not sure what the pattern from my first ANA test was but I want to say it was Speckled?  Anyway, when I saw my most recent results I thought 1. I didn't know you could have more than one ANA pattern and 2. Why is the pattern different from before? 

I know both Anti-Centromere and Anti-Nucleolar patterns are associated with scleroderma, but I hadn't heard of either of them being associated with Sjogren's Syndrome.  Any input would be greatly appreciated!

Thank you,
Shelly

[Nancy60]

Hi Shelly,
This is just from what I have read about ANA patterns and what they mean.  the pattern is caused by the different nuclear components the specific antibodies are targeting, so if you have SSA the pattern will be different than if you have DS-DNA.  There are many other antibodies that are not tested for that might be causing the ANA pattern.  There are charts available that tell you what patterns are common with which antibodies and this corelates with different diseases.  The pattern changing just indicates different antibodies present in your ANA which is why they also run the more specific tests (ie SSA,SSB, DS-DNA, etc...).  You really need to discuss this more with your doctor.  Ask him to explain it more to you so you can understand.

Hope this helps a little.
Nancy

[Shelly]

Hi Nancy,

Thank you so much for your response, it was very informative! I will be sure to ask my rheumatologist to explain ANA patterns to me in further detail, as this may mean a different treatment plan. 

Happy Holidays,
Shelly

[Flip]

I thought speckled was very specific for Sjogren's.  Mine is homogeneous but I think that one is sort of generic and can be associated with many different disorders such as Lupus.  I've never heard of someone's pattern changing.  Mine has always been homogeneous so I must wonder if you've developed an overlapping disease.

[Aquarius]

I have had a very high ANA, speckled with some homogeneous found. 

[SJSman]

Hello,

I haven't yet met any Rheumatologist who gave any consideration at all to ANA patterns, and I have seen three excellent ones.  They may as well not exist in the doctor's office.

I agree that they are interesting.  However, mine is nucleolar, which I believe is supposedly the "Scleroderma" pattern.  I have no symptoms of Scleroderma, and all symptoms of Sjogren's with pos SSB and pos lip biopsy.

I think that a lot existing information on line about ANA patterns is outdated, and that additional research will be required to get any useful information out of them.  That is just my experience, being sick for 12 years now.

If anyone's Rheumatologist explains how these are useful for any purpose, I would like to hear about it.  I don't know why the labs report the patterns is they are not useful for anything - as it appears.