Background/Purpose: Indirect Immunofluorescence (IIF) shows different nuclear and cytoplasmic fluorescence patterns depending on the antibodies present in the cell. Cytoplasmic patterns are an unusual finding. Their study is not standardized and their clinical value is unknown. The Cytoplasmic Discrete Speckles (CDS) pattern comprises several antigens distributed in the endosomes, lysosomes and GW bodies. The purpose of this study is to describe demographic and clinical characteristics of patients with CDS pattern on IIF in a cohort of patients.

Methods: This is a retrospective descriptive study. We included all patients with a CDS pattern on IIF on HEp-2 cells with a titer equal or greater than 1/80, using a database of all IIF performed in a referral laboratory of a universitary hospital between 2007 and 2015.

We analyzed demographical and clinical information available on their clinical records. We included sex, age, health history and symptoms compatible with autoimmune diseases.

Results: In that period of time, 7085 IIF studies were performed and 21 patients showed CDS pattern (0.29%). We reviewed 17 out of 21 clinical records. We excluded 4 patients that did not have clinical records at the hospital. All patients were female, with a median age of 62 (range 50-81 years). Demographics and clinical characteristics are shown in table 1. We found no relationship between the IIF titer, health history and symptoms compatible with autoimmune diseases. Fourteen of the patients (82%) had at least one symptom of autoimmune disease. Eight of the patients (47%) had an autoimmune disease, being Hashimoto Thyroiditis the most frequent one (50%).

A high rate of respiratory symptoms was observed among these patients. Six of them (34%) referred dyspnea and dry cough. They had different underlying causes, including chronic obstructive pulmonary disease (COPD). Symptoms description is shown in table 2.

Conclusion: CDS pattern is uncommon. We found no association with any particular disease, and none of our patients had any of the diseases described in other studies. Taking into account the low prevalence of this pattern and the heterogeneity of symptoms, the study of antibodies underlying this IIF pattern seems more useful for cell biology study than for clinical use.