Diseases and autoantibodies associated with HEP-2 patterns
HEP-2 positivity is found in many diseases but also in some physiological conditions (Table 10). Care should always be taken when interpreting positive results in patients. Elderly, especially females (41) and pregnant women frequently have ANA (42), albeit in rather low titer, as may patients with tumors, chronic infections and many other diseases. Autoantibodies may also appear months or years before overt manifestations of an autoimmune disease. Whilst the presence of autoantibodies are of great diagnostic importance, results have to be interpreted only in the context of the clinical information (42).

Currently, the determination of ANA is widely used as screening procedure for autoimmune diseases such as SLE, MCTD, Sjögren’s syndrome, RA, polymyositis, scleroderma, dermatomyositis and CREST syndrome (Calcinosis, Raynaud, Esophagus, Sclerodactylia, Telangiectasia).
The presence of positive ANA in patient sera is presumptive evidence of underlying autoimmune diseases, but it is not itself considered as diagnostic. However, absence of ANA may rule out a particular diagnosis (28). The observation that many autoantibodies appear before the clinical expression of disease suggests that they are not epiphenomena.

1) Physiologic changes in the concentration of ANA-factor
2) Pathologic changes in the concentration Antinuclear Antibodies (ANA)
a) Increased Antinuclear Antibodies (ANA) in:
Acquired hemolytic anemia (non-specific)
Anaplastic carcinomas or lymphomas (non-specific)
Atypical pneumonia (non-specific)
Dermatomyositis (specific)
Hepatic or biliary cirrhosis
Infectious Hepatitis (non-specific)
Leprosy (non-specific)
Malaria (non-specific)
Mixed connective tissue disease (specific)
Mononucleosis (non-specific)
Periaerteritis nodosa (non-specific)
Rheumatoid arthritis (non-specific)
Scleroderma (specific)
Sjörgen’s syndrome (specific)
SLE (specific)
Tuberculosis (non-specific)