line immunoblot assays (IBAs) using purified or recombinant autoantigens have become widely used.These assays enable the IntroductIonAutoantibodies against nuclear antigens (antinuclear antibodies) are key markers used in the diagnosis and monitoring of systemic autoimmune rheumatic diseases (SARDs) such as systemic lupus erythematosus (SLE), systemic sclerosis, Sjogren's syndrome, and mixed connective tissue disease (MCTD). 1,2The presence of ANA is typically detected using the indirect immunofluorescence assay (IIFA) on human epithelial (HEp-2) cells, which remains the gold standard due to its high sensitivity and the ability to discern a variety of nuclear, cytoplasmic, and mitotic patterns. 3These patterns offer important diagnostic clues and may reflect the underlying autoantibody profile.However, they are not disease-specific and require confirmation through antigen-specific assays. 4he International Consensus on ANA Patterns (ICAP) has standardized HEp2 IIFA pattern nomenclature to facilitate uniform interpretation and better clinical correlation. 5hile patterns such as homogeneous, speckled, nucleolar, centromere, and cytoplasmic staining are commonly seen, their association with specific autoantibodies or diseases varies across populations and regions.
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