The Prevalence and Clinical Relevance of the DFS Immunofluorescence Staining Pattern in a Large ANA-Positive Cohort

Abstract

BackgroundAlthough the dense fine speckled (DFS) immunofluorescence staining pattern has been studied by various researchers in recent years, its clinical associations remain unspecified. Thus, we performed a retrospective study in a non-selective population to explore the prevalence of this enigmatic antinuclear antibody (ANA) pattern and to determine its possible clinical associations with any identifiable pathology.MethodsWe retrieved the results of ANA testing ordered by various departments in 2019 to study the prevalence of DFS pattern. Demographic characteristics and clinical features of these participants were also collected from the electronic medical record system. Correlation analysis was made to study its clinical associations and a p-value < 0.05 was considered statistically significant.ResultsThe prevalence of ANA positivity was 37.4% among 72,204 serum samples of which the median age was 44 (interquartile range: 31, 56) years old and 68.0% were women. The prevalence of the DFS staining pattern was 1.1% in the total population and accounted for 3.1% in the ANA-positive population. There were 97.6% of these cases displaying the DFS pattern with a low titer of ANA (≤1:320; starting serum dilution: 1:100). We found that this pattern correlated with several pathological conditions, such as skin disorders (25.1%), alopecia (4.6%), and obstetric complications (6.6%).ConclusionThe presence of the DFS immunofluorescence staining pattern may accompany several pathological conditions and may be a signal of localized inflammation within certain organs or tissues, especially the skin.

Discriminating between Homogeneous (AC-1) and Dense Fine Speckled (AC-2) Antinuclear Antibody Patterns: Re-Evaluation of Immunofluorescence Imaging

“…The prevalence of the AC-2 pattern was reported to be between 0.3 and 27.0% in patients with ANA detection. In a large ANA-positive cohort, the prevalence of the AC-2 pattern accounted for 3.1%, and 97.6% of the positive AC-2 pattern cases displayed a low ANA titer of (≤1:320) [26]. An increasing trend over time of prevalence of anti-DFS70 autoantibodies was observed among the US population [27].…”