Antibodies Flashcards
anti-muscle-specific tyrosine kinase antibodies
Myasthenia gravis 40% #
but 85-90% of patients have antibodies to acetylcholine receptors
antibodies to acetylcholine receptors
Myasthenia gravis
85-90% of patients have antibodies to acetylcholine receptors. In the remaining patients, about about 40% are positive for anti-muscle-specific tyrosine kinase antibodies
Anti soluble liver antigen antibody positive
Autoimmune hepatitis 3
90% women, 30-50yr
2/3 get remission with corticosteroids….but 80% relapse after steroids stopped
Anti smooth muscle antibody,
ANA
Anti actin antibodies
Negative AMA…
indicate….
Autoimmune hepatitis type 1
Aged 10- elderly
Most common
Reasonable remission response with corticosteroids
Can have raised anti-DSDNA
What antibodies are usually present in multifocal motor neuropathy
GM1 anti ganglioside antibody in 80%
Antibody associated with neuromyelitis optica
NMO-IgG or antibodies against aquaporin 4
Normal MRI brain, spinal cord lesion involving 3 or more levels
Anti-centromere antibodies
Limited cutaneous systemic sclerosis
sclerodactyly, calcinosis, perioral puckering and gastro-oesophageal reflux symptoms in a middle-aged female
Anti GBM antibodies
Goodpastures
Anti-cardiolipin antibodies
Anti phospholipid syndrome
Also present in up to 10% of the general population
and found in around 30-40% of SLE.
In both patients with primary and SLE associated APS positive results correlate with a predisposition for arterial or venous thrombosis, foetal loss, or thrombocytopoenia.
Antibodies to acetylcholine receptors
Myasthenia gravis
Myasthenia gravis
Antibodies to acetylcholine receptors in 85-90%
Lambert Eaton Myasthenia Syndrome antibodies
Antibodies to voltage-gated calcium channels (VGCCs) have been reported in 75-100% of LEMS who have SCLC
50-90% of LEMS patients who don’t have underlying cancer
What conditions have ANA
Diffuse cutaneous systemic sclerosis Limited cutaneous systemic sclerosis Sjogren's syndrome SLE Autuimmune hep 1
Anti saccharomyces cerevisiae antibodies
More likely to be positive in Crohn’s
pANCA in which inflammatory bowel disease
More likely UC
Most likely antibody to be positive in SLE
ANA
anti-dsDNA and anti-Smith very specific but not sensitive
which ANCA is more assx w microscopic polyangiitis
pANCA (against MPO) - positive in 50-75%
cANCA (against PR3) - positive in 40%
pemphigus vulgaris antibodies
antibodies directed against desmoglein 3, a cadherin-type epithelial cell adhesion molecule
More common in Ashkenazi Jews
primary biliary cholangitis antibody
anti-mitochondrial antibodies (AMA) M2 subtype are present in 98% of patients and are highly specific
first-line: ursodeoxycholic acid
anti-phospholipase A2 antibodies
idiopathic membranous glomerulonephritis
anti-histone antibodies ( 80-90%)
Drug-induced lupus
ANA +ve
DsDNA -ve
specific test for lupus
anti-DsDNA
Typically associated with SLE but high levels may be found in autoimmune hepatitis
Anti-liver/kidney microsomal type 1 antibodies (LKM1)
autoimmune hepatitis 2
Affects children only
anti-ENA-antibodies
group of six tests: anti-Sm (SLE, highly specifc) anti-RNP (Mixed connective tissue disease and SLE). anti-Ro (Sjögren's, 70%) anti-La (Sjögren's 40%) anti-Scl70 (Scleroderma)
