Case 151: testing for rhumatologic disease. Case 152: A rhumatologic patient with joint pains ANA testing was negative who would you check for further sub-serology antibodies. 1- Anti-double standard DNA to role out lupus. 2- anti SCL-70 to role out scleroderma. 3- RNP for mixed connective tissue disease. 4- Anti-Jo1 in patient with myositis. Answer 4: see rationale below Don’t test ANA sub-serologies without a positive ANA and clinical suspicion of immune-mediated disease. Tests for anti-nuclear antibody (ANA) sub-serologies (including antibodies to double-stranded DNA, Smith, RNP, SSA, SSB, Scl-70, centromere) are usually negative if the ANA is negative. Exceptions include anti-Jo1, which can be positive in some forms of myositis, or occasionally, anti-SSA, in the setting of lupus or Sjögren’s syndrome. Broad testing of autoantibodies should be avoided; instead the choice of autoantibodies should be guided by the specific disease under consideration.
Posted on: Fri, 11 Jul 2014 16:05:51 +0000
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