Antibodies- simplified

Question 1

Anti-Ro

Answer 1

Sjogren’s syndrome

In lupus, risk of congenital heart block

Question 2

Anti-La

Answer 2

Sjogren’s

Neonatal lupus

Question 3

Anti Jo-1

Answer 3

Polymyositis
associated with pulmonary fibrosis and symmetrical polyarthritis

LUNGS AT RISK

Question 4

Anti Scl-70

Answer 4

diffuse cutaneous systemic sclerosis
Increase risk ILD
Lower risk renal involvement

Question 5

Anti-centromere

Answer 5

Limited cutaneous systemic sclerosis

Question 6

Anti-Sm

Answer 6

SLE and in particular renal and CNS disease

Question 7

U1RNP

Answer 7

Mixed connective tissue disease

Question 8

dsDNA

Answer 8

SLE

Drug induced lupus WHEN associated with TNF blockers

Question 9

RNA polymerase

Answer 9

systemic sclerosis

Suggests renal disease or severe skin involvement

Question 10

Th/To

Answer 10

limited cutaneous systemic sclerosis
poor outcome
pulmonary hypertension

Question 11

PM-SCl

Answer 11

polymyositis/scleroderma overlap syndrome

Question 12

Anti-Mi2

Answer 12

Dermatomyositis

• shawl sign
• good steroid response
• better prognosis

Question 13

Anti-SRP

Answer 13

Polymyositis 
or
Necrotising myopathy
-Rapid onset
-severe weakness
-poor response to steroids
-cardiac involvement

Question 14

pANCA these days means…

Answer 14

Anti-MPO

Question 15

cANCA these days means….

Answer 15

Anti-PR3

Question 16

Anti-PR3

Answer 16

Wegner's (90%)
Microscopic polyangitis (30%)

Question 17

Anti-MPO

Answer 17

Churg Strauss (50%)
Microscopic polyangiitis (70%)
Wegner's (10%)
Primary sclerosing cholangitis (most)
IBD

Question 18

RF

Answer 18

RA

Question 19

Anti-CCP

Answer 19

RA

Question 20

tRNA synthase

Answer 20

antisynthetase syndrome- up to 30% PM or DM are this

associated with acute onset, constitutional symptoms, myositis, Raynaud’s, mechanics hands, non errosive arthritis, and ILD THAT DRIVES THE MORBIDITY AND MORTALITY

Often also Anti Jo positive

treat with steroids and a sparin g agent, IV cyclo if lung disease

Question 21

biopsy findings

Answer 21

DM- perifasccular not infiltrating, more CD4 T cells (think skin, surface, perifascicular)

PM and IBM infiltrate INTO fascicles and more CD8 cells

inclusion bodies only 20-30% on biopsy
MRI can help distinguish- inflamm throughout muscle rather than along planes in DM

Question 22

anti 200/100 Ab

Answer 22

recognise HMG coA reductase protein in statin induced muopathy