Updated: 2/13/2018

Autoantibodies in Autoimmune Disease

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Snapshot
  • A 40-year-old woman with a past medical history of thyroid disease reports having chronically dry eyes and dry mouth for the past year. She has used artificial tears with some improvement. She also reports having pain with sexual intercourse and has been forced to use lubrication. Physical exam reveals dry mucous membranes and bilateral swollen parotid glands. Upon laboratory evaluation, she is positive for antinuclear antibodies, anti-Ro, and anti-La antibodies. (Sjögren syndrome)
Introduction
 
Autoimmune Antibodies
Disease
Antibodies
Systemic lupus erythematosus 
  • Antinuclear antibody
    • high sensitivity
  • Anti-double stranded DNA (dsDNA)
    • high specificity
    • helps monitor disease activity
  • Anti-Smith
    • highest specificity
  • Anti-cardiolipin
  • Lupus anticoagulant
Antiphospholipid syndrome 
  • Anti-β2 glycoprotein
  • Anti-cardiolipin
  • Lupus anticoagulant
Drug-induced lupus 
  • Anti-histone
    • high specificity
Sjögren syndrome 
  • Antinuclear antibody
  • Rheumatoid factor
  • Anti-ribonucleoprotein antibodies
    • SS-A (anti-Ro)
    • SS-B (anti-La)
Mixed connective tissue disease 
  • Anti-U1-RNP (ribonucleoprotein)
    • high specificity
Scleroderma 
  • Anti-Scl-70 (anti-DNA topoisomerase I)
    • high specificity
  • Anti-centromere
    • specific for limited scleroderma (CREST)
  • Anti-RNA polymerase III
  • Antinuclear antibody
    • nucleolar pattern is specific for systemic sclerosis
Dermatomyositis / Polymyositis 
  • Anti-synthetase (anti-Jo-1)
  • Anti-helicase (anti-Mi-2)
    • more specific for dermatomyositis
  • Anti-signal recognition particle (SRP)
    • more specific for polymyositis
  • Other antinuclear antibody (ANA) positive diseases
    • rheumatoid arthritis
    • juvenile arthritis
 

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