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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

Neurological Disease Antibodies