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Centromere Antibody

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I have localized scleroderma morphea. I have the results of my blood work back, most is pretty good. I have a question about one test, the centromere antibody test.


The results as shown on lab report:


centromere antibody <1:40 (reference range <1:40)

comment: 1:320 speckled pattern




If the centromere antibody test is negative, how can you have a 1:320 speckled pattern.


Does this mean that it is positive,... or does it mean that the very few antibodies

that they found, some of those have a speckled pattern.


Should I be concerned?


My rheumatologist has tried a burst of steroids, followed by Singular 10mg (yes the asthma drug), and after 2 weeks the red halo around my neck lesions appear

to be less...don't know what is making it a bit better,.. if it is the steroids or the Singular or the combination of the two. But I am hoping that it continues.


Best wishes to you all. I do not post often, but your website and this forum are

the fantastic.



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Good question, azrose. I had a quick look through the Antibody Test section of the medical page, but didn't find the precise information you are looking for. Hopefully someone else will be able to give you some help with this.

Warm wishes,



Carrie Maddoux

(Retired)ISN Sclero Forums Support Specialist

(Retired)ISN Sclero Forums UK Chat Host

International Scleroderma Network (ISN)

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Hi azrose,


I don't have specific info either, at least at the moment, but someone else might come along soon. If your post gets dropped to the bottom of the list, keep bringing it back to the top--just put in another response to your own post, and eventually someone should come along with the info. Sorry that I couldn't be of more help right away.


Best wishes to you,



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Hi Azrose,

Good to see you posting!


Unfortunately I don't have the answer, (I am really bad about understanding the lad stuff)! Maybe Janey will have an answer for you.


Keep on posting!




Lisa Bulman

(Retired) ISN/SCTC List Coordinator

(Retired) ISN Sclero Forums Assistant Manager

(Retired) ISN Assistant News Guide

(Retired) ISN Fundraiser

International Scleroderma Network (ISN)

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Yes, this whole antibody thing is very confusing! It's questions like your's that help us learn just a little bit more. I did some research and in an article from the American College of Rheumatology, I found the following:


The patterns correspond to different antigens that have bound to autoantibodies in the patient’s blood. Homogeneous, speckled, nucleolar and centromere patterns refer to staining of different parts of the cell nucleus, whereas cytoplasmic staining refers to staining of antigens in the cytoplasm. Each pattern is significant. For instance, a nucleolar pattern suggests a diagnosis of diffuse cutaneous systemic sclerosis (scleroderma), whereas a centromere pattern is associated with the limited cutaneous form of systemic sclerosis (scleroderma), in particular the CREST syndrome (an acronym standing for Calcinosis, Raynaud’s phenomenon, Esophageal dysmotility, Sclerodactyly, Telangiectasias). Homogeneous and speckled nuclear and cytoplasmic patterns are less disease-specific.


So from this it looks like a speckled pattern and centromere are two different antigens and two different indicators. I hope this helps.


Big Hugs,

Janey Willis

ISN Support Specialist

(Retired) ISN Assistant Webmaster

(Retired) ISN News Director

(Retired) ISN Technical Writer for Training Manuals

International Scleroderma Network (ISN)

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Thank you all for your response.


Janey and Pamela,


Should I be concerned? I guess I am confused. My ACA is negative--which from what I read regarding localized scleroderma, having a positive response means

you are more like likely to one date have systemic scleroderma....mine is negative, that is good.


But how significant is the speckled pattern, in combination with a negative ACA.

Could the fact that I have localized scleroderma morphea be triggering the speckled pattern, or does it indicate that I may have a problem with systemic scleroderma in the future.


I understand from your posts that they are two different things....you are right

these are very confusing.


Thanks again



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Unfortunately the medical community is still trying to figure out all the ins and outs of it as well. An ANA with Speckled pattern can indicate a variety of autoimmune disorders such as Lupus, or Mixed connective tissue disease, or Sjogrens, and a speckled/nucleolar combo can indicate scleroderma, so until more symptoms and other results start manifesting themselves, it's really hard for the doctors to give you a clear cut answer. :( I know this probably didn't answer your questions, but as you'll find out, this is all a muddled mess at times, and I've just learned to roll with it.


I actually was given the Lupus diagnosis my first visit. Then the Scleroderma didn't surface for another couple of years. It's been 7 years now for me and Sjogrens just came into the picture.


Hang in there and keep learning and some of the puzzle will start to fall into place for you.

Warm and gentle hugs,



ISN Support Specialist

International Scleroderma Network (ISN)

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I just wanted to let you know that I also have an ANA speckled pattern 1:320 with a negative ACA. However, I have Mixed Connective Tissue Disease because I also have a high RNP antibody. Have you been tested for many other antibodies as well. Sometimes that can help paint a better picture of your disease pattern.



In my case, I have morphea-like skin patches with an over-production of collagen in the affected areas revealed by biopsy. I have used high dose steriods with plaquenil, and UVA-1 light therapy with good results.


Stay positive!



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Thanks to all of you that replied.


I will do what Pamela says, basically try not to worry about it, until when and

if any other symptoms appear, because there are just too many variables.


My ANA was neg

My ACA was neg, (1:40) but 1:320 had a speckled pattern wrote in as a comment

My anti dsDNA was neg

MY anti SCL 70 was neg

My Anti SM/rnp was neg

histone IGG neg

Anti SSB neg

anti SSA neg

ACE 58, elevated, doctor says indicative to sarcoidosis, but could be other things and was not concerned

Rheumatoid factor normal


So overall I think I am doing fine. The steroid burst and the drug Singulair

has helped my morphea a lot....So I am one lucky lady.


I want to thank you all again, you helped me understand that this is all very complicated, and unless you are having symptoms, it does you no good to worry about what may or may not happen in the future. I too am just going to try to

"roll with it". It could be a lot worse than Morphea.


Best Wishes



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Hi there Azrose,


I see that you have Morphea. I think you are on the right track and you dont have anything to worry about unless you have symptoms that say otherwise. You were neg. on all of your antibody tests except the ACA, which was 1:320 in a Speckled pattern. It is common for a handful of people to have a positive ACA especially if any autoimmune stuff runs in your family. Chances are you will never aquire other illness's that are associated with a pos. ACA.


This is all just my oppinion, and your doctor would have the most important and final say in this matter. :)




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I had ANA positive with speckled pattern when I was diagnosed with Scleroderma.


Kind regards,





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