Rheumatology

Question 1

ANA

Answer 1

Normal <1:80
SLE
Primary autoimmune cholangitis
Drug induced lupus
Systemic sclerosis
Sjogrens
Scleroderma (speckled)
Autoimmune hepatitis

If ANA negative can’t have ENA/dsDNA

Question 2

ENA

Answer 2

• Anti-Smith - SLE most specific
• Anti-Ro/Anti-La - neonatal lupus
• Anti-Ro - juvenile dermatomyositis
• Anti-La - SLE, Sjogrens
• Anti-RNP - SLE, scleroderma, mixed connective tissue disease
• Anti-Jo - juvenile dermatomyositis (marker of lung disease)
• dsDNA - SLE disease activity/most prevalent
• C3 - SLE disease activity
• Anti-histone - drug induced SLE
• cANCA - Wegeners
• pANCA - Churg Strauss SLE
• RhF - Rheumatoid arthritis, Sjogrens, MCTD, SLE
• Antiphospholipid antibodies - thromboses, SLE (can be normal, check twice 6 weeks apart)
• HLAB27 - IBD, ankylosing spondylitis
• Anti Smooth Muscle Ab - autoimmune hepatitis