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The correspondence of Deng et al 1 raises practical issues regarding the recognition and clinical interpretation of the nuclear dense fine speckled (DFS, AC-2) pattern in a typical clinical immunology laboratory during antinuclear antibody (ANA) screening using indirect immunofluorescence assay on HEp-2 cells (HEp-2 IIFA). Based on the recommendation of the International Consensus on ANA Patterns (ICAP),2 the recognition of a nuclear DFS pattern is not to be taken as the same as the determination of an anti-DFS70 antibody using a follow-up specific immunoassay. In fact, HEp-2 IIFA is a screening test for a vast array of autoantibodies and is not intended for the final determination of autoantibody specificity. Accordingly, the ICAP recommendation is clear that all HEp-2 IIFA patterns as defined by ICAP, with the sole exception of anti-centromere (AC-3), must be followed-up with specific immunoassays.2 With specific …
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