== Data on CRP, aCL IgGand IgM, b2-IgG&IgM, lupus anticoagulant, and direct Coombs test are represented as n(%)

== Data on CRP, aCL IgGand IgM, b2-IgG&IgM, lupus anticoagulant, and direct Coombs test are represented as n(%). DCT. Results: Of the 204 samples, the most frequent ANA pattern observed was nucleus speckled (52.9%), Rabbit polyclonal to CIDEB followed by nucleus homogenous (27.5%), mixed (13.7%), and cytoplasm speckled (5.9%). The nucleus homogenous pattern showed the most pathogenic immune profile due to its close association with markers of disease activity, namely, high anti-dsDNA titer, low C3 level, and DCT positivity. Conclusion: This study showed that the most common pattern associated with SLE Upamostat is nucleus speckled, followed by the nucleus homogenous pattern. Based on associations with specific serological markers, the nucleus homogenous pattern may be linked to a high disease activity in SLE. Keywords:anti-dsdna, rheumatic diseases, direct coomb’s test, sle, indirect immunofluorescence, ana == Introduction == Systemic lupus erythematosus (SLE) is a systemic chronic inflammatory autoimmune disorder that affects multiple organs. It predominantly affects women, with a female-to-male ratio of 6-12:1 and a peak incidence during the reproductive age span [1,2]. One of the challenging aspects of SLE is the wide spectrum of clinical manifestations due to multisystem involvement and the progressive nature of the disease. Another hallmark of SLE is its association with a wide array of immune/serological markers. The identification of any serological abnormality and associated features contributes to the diagnosis of SLE and helps monitor the Upamostat prognosis of the disease. The European Alliance of Associations for Rheumatology/American College of Rheumatology (EULAR/ACR) classification criteria for SLE include identification of antinuclear antibodies (ANAs), antiphospholipid antibody (APLA), and low complements levels [3]. The clinical criteria are grouped into seven clinical domains (constitutional, hematological (leukopenia, haemolytic anaemia, and thrombocytopenia), mucocutaneous, musculoskeletal, serosal, renal, and neuropsychiatric). In accordance with the criteria, the detection of ANAs is a key component considered under the immunological domain, and therefore, a positive ANA test is required for a patient to be classified as having SLE [4]. ANAs are a group of autoantibodies to cell nuclear antigens (nucleic acid, protein, and their complexes) [5]. In SLE, autoantibodies are frequently targeted against intracellular antigens of the cell nucleus (double-stranded DNA (dsDNA), histones, and other extractable nuclear antigens (ENAs)) and cell cytoplasm (ribosomal P protein) [6]. The criteria define ANA positivity as the presence of ANAs by immunofluorescence assay at a titre of 1 1:80 or greater on HEp-2 cells or another solid-phase assay with equivalent performance [7]. This study was performed to detect the most common ANA patterns among ANA-positive SLE patients, and the patterns were compared with the associated antibodies and other specific immunologic markers. == Materials and methods == A retrospective study was conducted at the Department of Rheumatology and Microbiology at Sri Ramachandra Medical College and Research Institute, Chennai, India, after obtaining approval from its Institutional Ethics Committee (approval number: IEC-NI/23/AUG/88/55). Data collected from January 2019 to May 2023 were used for this study. The inclusion criteria were as follows: consecutive samples of ANA-positive SLE patients newly diagnosed based on the EULAR/ACR criteria, belonging to all age groups. The exclusion criteria were as follows: ANA-negative SLE patients, duplicate samples from the same patient, and patients with no ANA pattern result. Patient demographic data and laboratory investigation Upamostat reports of ANA titres, C3, C4, anti-cardiolipin antibodies (aCL), beta2-glycoprotein I (2GP1), lupus anticoagulant (LAC), C-reactive protein (CRP), and direct Coombs test (DCT) results were collected from the Hospital Information System and electronic files from the Medical Records Department. ANA indirect immunofluorescence ANA by indirect immunofluorescence (IIF) testing is usually processed using BIOCHIP titre plane slides coated with HEp-20-10-HEp-2 and tissue sections of monkey hepatocytes-primate liver (Euroimmun, Germany). Slides containing fixed cells (HEp-20-10) were incubated with patient serum diluted with phosphate buffer saline. The dilution range starts from 1:100, and positive samples were further diluted by a factor of 10, 1:1000. The test procedure was then carried out as per the kit insert. Fluorescence and pattern were visualized using a fluorescence microscope at x400 magnification, and based on the intensity of the positive control,.