Auto-antibody testing
Systemic autoimmune rheumatic diseases (SARDs) are characterized by autoantibodies that can affect tissues and organs throughout the body.
Indications for Testing
SLE: rash, photosensitivity, oral ulcers, polyarticular arthritis, proteinurea, pleuritis, pericarditis, interstitial nephritis, fatigue, cytopenia, seizures or psychosis
Sjögren syndrome: dry mouth, dry eyes
Mixed or undifferentiated connective tissue disease: Raynaud syndrome, joint aches, puffy fingers, low-grade myositis
Systemic sclerosis: Raynaud syndrome, sclerodactyly, interstitial lung disease/pulmonary hypertension, gastroesophageal reflux
Inflammatory myopathies (including polymyositis, dermatomyositis): progressive muscle weakness (usually proximal), with or without rashes
Antinuclear antibody (ANA)
ANA positivity is found in many CTDs but has poor specificity.
An ANA panel may be positive in healthy individuals (and particularly with increased age) or be induced transiently during acute illness or with infection, and by certain medication.
Nevertheless, a negative ANA test, has a high negative predictive value/sensitivity for SLE (a negative test reliably excludes a diagnosis of SLE)
Antinuclear antibody (ANA)
Anti-dsDNA antibody dsDNA
Anti-Smooth muscle antibody SMA
Anti-Ro antibody
Anti-La antibody
Anti-histone antibody
Anti-ribonucleolar protein antibody Anti-RNP
Anti-centromere antibody
Anti-Scl-70 antibody
Anti-Jo-1antibody
Anti-Ro52, Anti-Ro60 antibodies
Anti-cyclic citrullinated peptide antibody (Anti-CCP)
Rheumatoid Factor antibody
Anti-cardiolipin (aCL) antibody, Lupus anticoagulant
Anti-neutrophil cytoplasmic antibody (ANCA)
Anti-Glomerular Basement Membrane antibody (GBM)
Anti-Gastric Parietal Cell Antibodies & Anti-Intrinsic Factor antibodies
Anti-Mitochondrial antibody
Anti-Smooth Muscle antibody
Anti-Liver Kidney Microsomal antibody
Anti-Thyroid peroxidase (TPO) antibody
Anti-TSH receptor antibody
IgA Anti-Tissue Transglutaminase (tTG) antibody
Anti-Endomysial antibody (EMA)
Anti-Saccharomyces cerevisiae antibody
Anti-Striated Muscle antibody
Anti-Skin Antibody
Anti-Adrenal Cortex Antibody
Anti-Islet Cell, anti-IA2 and anti-GAD65 Antibodies
Polymyositis/dermatomyositis, Rheumatoid arthritis,
Scleroderma,Raynaud, Sjögren’s syndrome, SLE
Systemic lupus erythematosus
Systemic lupus erythematosus
Sjögren’s, SLE, neonatal lupus (congenital heart block)
Sjögren’s, SLE
Drug-induced Lupus
SLE, Mixed Connective Tissue Disease
CREST syndrome systemic sclerosis, Sjögren’s syndrome
Diffuse systemic sclerosis (scleroderma), SLE
Polymyositis, dermatomyositis
Polymyositis
Rheumatoid Disease
Rheumatoid Disease, Sjögren’s, SLE
Antiphospholipid syndrome
Systemic vasculitis, Wegener’s Granulomatosis, Churg-Strauss
Goodpasture’s Syndrome
Autoimmune gastritis and pernicious anaemia
Primary Biliary Cirrhosis
Type 1 Autoimmune Hepatitis
Type 2 Autoimmune Hepatitis (more common in children)
Hashimoto's thyroiditis, primary myxoedema, Graves’ disease
Graves’ disease
Coeliac Disease (FN if IgA deficient, if so, test IgG anti-tTG)
Coeliac Disease
More common in Crohn’s disease than Ulcerative Colitis
Thymoma in myasthenia gravis
Bullous Pemphigoid, Pemphigus vulgaris
Autoimmune adrenal failure (Addison’s disease)
Type 1 (autoimmune) diabetes