Background Anti nuclear antibodies (ANA) are one of the key diagnostic analyse for autoimmune diseases in rheumatological practice. The staining patterns of ANA include two main subgroups; nuclear and cytoplasmic staining patterns. In clinical practice the main five nuclear staining patterns (homogen, peripheral, granular, centromer, nucleolar)are used for diagnosis. The clinical significance of cytoplasmic patterns is unclear.

Objectives We aimed in this study to determine the clinical significance of rarely seen ANA staining patterns.

Methods Our study group is consisted of 224 patients (40 male, 184 female) who admitted with arthralgia to rheumatology outpatient clinic and found ANA positivity with the titer at least 1/320. ANA analysing was performed with IFA (Euroimmun) and ENA with immune blot (Euroimmun).

Results The frequency of homogeneous pattern was 13,8%, granular pattern 19,6%, cytoplasmic pattern 17%, centromer 5,4%, nucleolar 16,5%, nucleolar granular 4,9%, nucleolar homogenous 4,9%, mitbody 10,3%, actine 4,5%, vimentin 3,1%, tropomyosin 0,9%, fibrillarin 1,3%, peroxisomes 2,2%, pcna 1,8%, golgi 2,7%, spindle fiber 3,6%, lamin 2,2%, centriol 3,6%, ribosomal-p 2,7%, mitochondrial 1,8%. The distribution of ANA patterns according the clinical findings is shown in Table-1. We found that rarely seen patterns could be associated with autoimmune diseases. Cytoskleton related patterns are associated with SPA in comparing to the other patterns. Nucleolar homogeneous, nucleolar granular, golgi and mitochondrial patterns are found the most spesific patterns in our study. The most RA associated patterns are found homogeneous and mitbody patterns. The most nonspesific patterns were granular in commen patterns and centriol in rarely seen patterns.

Conclusions The rarely seen patterns may be significant for autoimmune diseases. The titre and the descriptive pattern information should be reported for rarely seen patterns.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.6079