Cytoskeletal

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Cytoskeletal

This sample is demonstrating an anti-cytoskeletal pattern in the cytoplasm of the cells.

The cytoskeleton of eukaryotic cells is comprised of microfilaments such as actin, intermediate filaments such as vimentin and microtubules such as tubulin. Autoantibodies to these proteins are seen in a variety of autoimmune diseases.

Whenever an ANA is read the first step is to see if there is a clearly discernible pattern in the nucleus of the interphase cells. In this case the answer is no (a). However, there is considerable staining in the cytoplasm. This fibrous staining of the cytoskeleton is a discernible cytoplasmic pattern and should be reported (b).

This sample is reported as ANA Negative, suspect cytoskeletal antibodies present. (The term "suspect" is used because the ANA substrate is not considered "confirmatory" for the identification of cytoskeletal antibodies. Additional follow-up testing is required).

Follow-up testing would include testing for anti-smooth muscle antibodies. Anti-smooth muscle antibodies are seen in autoimmune liver disease.

Reporting anti-Cytoskeletal Antibodies:
Cytoplasmic pattern:
• Fibrous strands in cytoplasm

Report as:
• Suspect cytoskeletal, suggest follow-up

Clinical Significance:
• Actin: Autoimmune hepatitis, PBC
• Vimentin and others: SLE, RA, others