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AC-8 - Homogeneous Nucleolar
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Found in patients with SSc, SSc-AIM overlap syndrome, and patients with clinical manifestations of other SARD.
If limited cutaneous SSc is clinically suspected, it is recommended to perform a follow-up test for anti-Th/ To antibodies; the antigen is included in disease specific immunoassays (ie, SSc profile).
If SSc-AIM overlap syndrome is clinically suspected, it is recommended to perform a follow-up test for anti-PM/Scl antibody reactivity; the antigen may be included in the routine ENA profile and is included in disease specific immunoassays (i.e., inflammatory myopathy profile* and the SSc profile); in general, anti- PM/Scl antibodies yield a diffuse nuclear fine speckled staining in addition to the AC-8 pattern.
Other antigens recognized include B23/nucleophosmin, No55/SC65, and C23/nucleolin, but the clinical significance of these autoantibodies is not well established; specific immunoassays for these autoantibodies are currently not commercially available.
Although some anti-Th/To antibody immunoassays are commercially available, technical issues relating to the limited sensitivity of these immunoassays should be taken in to consideration.
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The AC-8 pattern that is the result of the anti-Th/To reactivity is also seen in patients with SLE, UCTD (i.e., patients with rheumatic symptoms without a SARD diagnosis), SSc sine scleroderma, idiopathic interstitial lung disease or pulmonary hypertension.
Patients with autoantibodies revealing the AC-8 pattern due to anti-PM/Scl reactivity may have, in addition to the clinical features of AIM and SSc, various clinical manifestations of SLE and SjS.