ArticleClinical chemistry and laboratory medicine2026
ANA fluorescence patterns and low C4 are associated with higher antiphospholipid antibody serological intensity in routine diagnostic testing.
Article in Clinical chemistry and laboratory medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo evaluate whether antinuclear antibody (ANA) titre or HEp-2 fluorescence patterns are associated with antiphospholipid antibody (aPL) serological intensity, and to examine component-specific complement abnormalities - particularly low C4 - as laboratory correlates compatible with classical-pathway involvement.
methodsThis retrospective cross-sectional study analysed 626 consecutive diagnostic samples with same-day testing for lupus anticoagulant (LA), anticardiolipin (aCL), anti-β
resultsOverall, 26.5 % of samples (166/626) were aPL-positive, including 1.6 % triple-positive cases (10/626). High-titre ANA (≥1:160) was not associated with higher aPL serological intensity (OR 1.00, 95 % CI 0.51-1.96). In contrast, homogeneous (OR 1.99, 95 % CI 1.26-3.18) and speckled (OR 2.85, 95 % CI 1.66-4.91) ANA patterns were independently associated with higher aPL categories. Low C4, - but not low C3 - was associated with aPL positivity in binary analysis (Firth OR 6.84, p=0.001; low-C4 events n=10).
conclusionsANA fluorescence patterns, but not ANA titre, are associated with higher aPL serological intensity, indicating a distinct laboratory serological phenotype. Low C4 shows an association compatible with classical-pathway complement involvement. These findings are observational and require validation in longitudinal studies.
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