AC-20 - Fine Speckled

Scattered small speckles in the cytoplasm mostly with homogeneous or dense fine speckled background. e.g. anti-Jo-1.
Associação Antigênica
Jo-1/histidyl-tRNA synthetase
Doença Associada
anti-synthetase syndrome, PM/DM, limited SSc, idiopathic pleural effusion
Relevância Clínica (Primeiro Nível)
Found in patients with the anti-synthetase syndrome (a subset of AIM), interstitial lung disease, polyarthritis, Raynaud’s phenomenon, and mechanic’s hands; these features may occur in various combinations or as an isolated manifestation, especially interstitial lung disease
Autoantibodies associated with the AC-20 pattern are primarily reported for the anti-Jo-1 antibody, which recognizes histidyl-tRNA synthetase; since AC-20 is not specific for Jo-1, it is recommended to perform a follow-up test for anti-Jo-1 antibodies; the antigen is included in the routine ENA profile, as well as in disease specific immunoassays (i.e., inflammatory myopathy profile*); the anti-Jo-1 antibodies are included in the classification criteria for AIM.
The fine distinction between AC-19 and -20 may depend on HEp-2 substrates and/or antibody concentration; antibodies to Jo-1 may be undetected in HEp-2 IIFA-screening.
Fritzler MJ, Choi MY, Mahler M. The antinuclear antibody test in the diagnosis of antisynthetase syndrome and other autoimmune myopathies. J Rheumatol 2018;45:444.1–5.

Lundberg IE, Tja?rnlund A, Bottai M, et al. 2017 European league against rheumatism/American college of rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Ann Rheum Dis 2017;76:1955–64.

Marie I, Hatron PY, Cherin P, et al. Functional outcome and prognostic factors in anti-Jo1 patients with antisynthetase syndrome. Arthritis Res Ther 2013;15.

Satoh M, Tanaka S, Ceribelli A, et al. A comprehensive overview on myositis-specific antibodies: new and old biomarkers in idiopathic inflammatory myopathy. Clin Rev Allergy Immunol 2017;52:1–19.