Dr Mohammadreza Sheikh Sajjadieh, Olena Sheikh Sajjadieh, Ghazaleh Aghababaei, Mohammad Farzi, Dr Abdolsamad Ghorbany,
Volume 20, Issue 2 (6-2026)
Abstract
Anti-centromere antibodies (ACA) are most commonly identified by indirect immunofluorescence (IIF) on HEp-2 cells, where they usually produce the characteristic centromere pattern (AC-3) associated with limited cutaneous systemic sclerosis. With the increasing routine use of solid-phase assays such as ELISA, situations arise in which assay results do not fully align. We report the case of a 75-year-old woman with features suggestive of systemic autoimmune disease whose ANA testing by IIF demonstrated a multiple nuclear dots pattern (AC-6) with elements resembling a CENP-F–like pattern (AC-14), rather than the classic centromere pattern. In contrast, solid-phase testing detected anti-centromere reactivity. This case illustrates how pattern recognition on IIF and antigen-specific assays may diverge and underscores the importance of interpreting serologic results within clinical context and across complementary laboratory platforms.
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