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Discordant Detection of Anti-Centromere Antibodies by Indirect Immunofluorescence and ELISA: A Case Report and Diagnostic Considerations
Mohammadreza Sheikh Sajjadieh1 , Olena Sheikh Sajjadieh2 , Ghazaleh Aghababaei3 , Mohammad Farzi4 , Abdolsamad Ghorbany5
1- Member of AIMS Australia, and, Consultant Clinical Immunology, Padtan Danesh Company, Tehran, Iran , mohammad_esfahan@yahoo.com
2- MBBS, General Practitioner, Australia
3- Technical Officer, Padtan Danesh Company, Tehran, Iran
4- CEO, Padtan Danesh Company, Tehran, Iran
5- Doctorate of laboratory medicine, Vahid Laboratory Director, Isfahan, Iran
Abstract:   (2509 Views)
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.
 
Keywords: Anti-centromere antibodies (ACA), Indirect immunofluorescence (IIF), ELISA, ANA patterns (AC-3, AC-6, AC-14), CENP-F–like pattern
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Research Article: Case Report | Subject: Immunology
Received: 2026/01/2 | Accepted: 2026/06/6
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