Discrimination of antineutrophil antibodies from antinuclear antibodies using immunofluorescence on neutrophils and HL60 cells.

Sera of 209 patients with rheumatic disease demonstrated 3 patterns of immunofluorescence (IF) on ethanol fixed neutrophils (PMN) and a promyelocytic cell line (HL60): (1) cytoplasmic on PMN, negative on HL60 cells, (2) nuclear or perinuclear on PMN, negative on HL60 and (3) nuclear or perinuclear on both PMN and HL60 cells. Pattern 1 was observed in sera of patients with Wegener's granulomatosis, but also in several patients with other rheumatic diseases. Pattern 2 was observed in sera of patients with systemic vasculitis or rheumatoid arthritis (RA). Antimyeloperoxidase activity was detected in sera from patients with systemic vasculitis that produced Pattern 2, but rarely in sera of patients with RA that produced the same IF pattern. Pattern 3 was observed in sera that contained antinuclear antibodies as detected by IF on HEp-2 cells.