Here is a list of some common antibodies associated with rheumatologic diseases:
Systemic Lupus Erythematosus (SLE)
- Antinuclear Antibodies (ANA): The most common screening test; positive in most SLE patients.
- Anti-dsDNA (anti-double-stranded DNA): Highly specific for SLE, associated with lupus nephritis.
- Anti-Sm (Smith Antibody): Highly specific for SLE, though less common than anti-dsDNA.
- Anti-Ro/SSA and Anti-La/SSB: Associated with neonatal lupus, Sjögren’s syndrome, and photosensitive skin rashes in SLE.
- Antiphospholipid Antibodies (aPL): Including anticardiolipin antibodies, lupus anticoagulant, and anti-beta-2 glycoprotein I; linked to antiphospholipid syndrome in SLE.
Rheumatoid Arthritis (RA)
- Rheumatoid Factor (RF): Present in about 70-80% of RA patients.
- Anti-Cyclic Citrullinated Peptide (Anti-CCP): Highly specific for RA, predictive of erosive disease.
Sjögren’s Syndrome
- Anti-Ro/SSA and Anti-La/SSB: Found in a majority of primary Sjögren’s patients, also overlap with SLE.
Systemic Sclerosis (Scleroderma)
- Anti-Scl-70 (anti-topoisomerase I): Associated with diffuse cutaneous systemic sclerosis.
- Anti-centromere antibodies: More specific for limited cutaneous systemic sclerosis (CREST syndrome).
- Anti-RNA Polymerase III: Linked to rapidly progressive skin changes and increased risk of renal crisis.
Polymyositis/Dermatomyositis
- Anti-Jo-1 (anti-histidyl-tRNA synthetase): Associated with interstitial lung disease and arthritis in myositis.
- Anti-Mi-2: Found in some patients with dermatomyositis, associated with better prognosis regarding muscle disease.
Mixed Connective Tissue Disease (MCTD)
- Anti-U1-RNP (anti-ribonucleoprotein): High titers are characteristic of MCTD.
Vasculitis
- Anti-Neutrophil Cytoplasmic Antibodies (ANCA):
- c-ANCA (PR3-ANCA): Associated with granulomatosis with polyangiitis (Wegener’s).
- p-ANCA (MPO-ANCA): Seen in microscopic polyangiitis and Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis).
Spondyloarthropathies
- HLA-B27: Not an antibody but a genetic marker associated with ankylosing spondylitis, reactive arthritis, and psoriatic arthritis.
Other Notable Antibodies:
- Anti-RNP (Ribonucleoprotein): Can be seen in various autoimmune conditions, including MCTD.
- Anti-SS-A/Ro and Anti-SS-B/La: As mentioned, not exclusive to one disease; also seen in subacute cutaneous lupus erythematosus.
Considerations:
- The presence of an antibody does not always mean the disease is present, and absence doesn’t rule it out; clinical correlation is crucial.
- Some antibodies can be found in healthy individuals or with other autoimmune conditions (overlap syndromes).
- Diagnosis of rheumatologic diseases often requires a combination of clinical findings, imaging, and other laboratory tests in addition to antibody testing.
When interpreting these results, it’s vital to work with a rheumatologist or healthcare provider who can synthesize all clinical data to reach an accurate diagnosis.
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