Antinuclear antibody positive granulomatous type suggests the possibility of connective tissue disease, should be combined with whether the patient has fever, hair loss, dry mouth, arthralgia and other manifestations of further investigation of the primary disease. Antinuclear antibodies (ANAs) are a group of autoantibodies that target various components of eukaryotic cells, such as deoxyribonucleoproteins, DNA, RNA and extractable nuclear antigens, and are one of the most important diagnostic indicators of autoimmune diseases. According to the distribution site of anti-nuclear antibodies, anti-nuclear antibodies are categorized into anti-DNA, anti-histone, anti-non-histone, anti-nucleolus antibodies and anti-other cellular component antibodies. There are five main types of antibody nucleotypes detected by immunofluorescence, namely, homogeneous, granular, nuclear membrane, nucleolus, and filament type. The granulomatous type is caused by anti-ENA antibody (a type of antigen extracted from cell nuclei by salting out method and does not contain DNA, belonging to anti-nonhistone antibody). Positive granulomatous type of anti-nuclear antibody is commonly found in mixed connective tissue disease, and also in autoimmune diseases such as systemic lupus erythematosus, scleroderma, and desiccation syndrome. It should be considered in conjunction with whether the patient has fever, hair loss, dry mouth, arthritis and pain. It is recommended to consult the rheumatology and immunology department in time for antinuclear antibody-positive granulomatous type, and improve the relevant examinations under the guidance of the doctor to make a clear diagnosis and early treatment.