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Dermatology
Autoantibodies Encountered in Patients with Autoimmune Connective Tissue Diseases
Built from Dermatology, 5th Edition
What’s inside
9 sections · 74 slides
Overview
- What this topic covers
What autoantibodies are and why we test for them
Autoimmune connective tissue disease basics
- What is an autoimmune connective tissue disease (AI-CTD)?
- What is an anti-nuclear antibody (ANA)?
The fluorescent ANA test
History, technique, and how to read a result
- Evolution of autoantibody testing
- The fluorescent ANA (FANA) test
- Methods for autoantibody detection
- Why human HEp-2 cells replaced rodent cells
- Why an ANA titer can vary between tests
- Automated immunoassays: ELISA and bead-based tests
- "Normal" versus "abnormal" ANA titers
- Interpreting an ANA result correctly
- Interpreting ANA test results
- Sensitivity, specificity, and predictive value in laboratory testing
- Immunofluorescence patterns on the FANA test
- Immunofluorescence patterns of anti-nuclear antibodies
- Clinical utility of the ANA test in SLE
- 98%
- What autoantibody testing is actually used for
- Sontheimer's corollary to Greenwald's law of lupus
- ANA testing before phototherapy
- Approach to suspected cutaneous lupus erythematosus
Autoantibodies in lupus erythematosus
Which autoantibodies matter, and why
- Autoantibodies and lupus: the big picture
- Autoantibodies associated with lupus erythematosus
- Autoantibodies associated with lupus erythematosus (continued)
- Autoantibodies associated with lupus erythematosus (continued)
- Autoantibodies associated with lupus erythematosus (continued)
- Autoantibodies associated with lupus erythematosus (continued)
- Anti-dsDNA antibodies
- Anti-SSA/Ro and anti-SSB/La antibodies
- Ro52/Ro60 antibody combinations and disease links
- Drug-induced ANA and drug-induced lupus
- Drug-induced subacute cutaneous lupus (SCLE)
- TNF inhibitors and induced autoantibodies
Autoantibodies in dermatomyositis and polymyositis
The idiopathic inflammatory dermatomyopathies
- What are the idiopathic inflammatory dermatomyopathies?
- Autoantibodies in idiopathic inflammatory dermatomyopathies
- Autoantibodies in idiopathic inflammatory dermatomyopathies (continued)
- Autoantibodies in idiopathic inflammatory dermatomyopathies (continued)
- Autoantibodies in idiopathic inflammatory dermatomyopathies (continued)
- Anti-TIF1-γ (p155) and anti-TIF1-α (p140) antibodies
- Anti-MDA5 antibodies (anti-CADM-140)
- Anti-Jo-1 antibodies and antisynthetase syndrome
- Anti-Mi-2, anti-SRP, anti-NXP-2, and anti-SAE antibodies
Autoantibodies in systemic sclerosis and morphea
Scleroderma and localized scleroderma
- What is systemic sclerosis (SSc)?
- Autoantibodies associated with systemic sclerosis
- Anti-RNA polymerase III and cancer-associated scleroderma
- Autoantibodies in morphea (localized scleroderma)
Autoantibodies in other rheumatic disorders and vasculitis
Rheumatoid arthritis, Sjogren syndrome, MCTD, and ANCA
- Autoantibodies in rheumatoid arthritis and Sjogren syndrome
- Autoantibodies associated with other rheumatic diseases having cutaneous manifestations
- Autoantibodies associated with other rheumatic diseases having cutaneous manifestations (continued)
- Mixed connective tissue disease (MCTD)
- Clinical and serologic overlap in autoimmune connective tissue disease
- What are anti-neutrophil cytoplasmic antibodies (ANCA)?
- Two patterns of ANCA and their classic disease links
- Approach to the patient with cytoplasmic ANCA
- Approach to the patient with perinuclear ANCA
- Other diseases linked to ANCA
- Other disorders associated with anti-neutrophil cytoplasmic antibodies (ANCA)
- Other disorders associated with anti-neutrophil cytoplasmic antibodies (ANCA) (continued)
- Other disorders associated with anti-neutrophil cytoplasmic antibodies (ANCA) (continued)
- Other disorders associated with anti-neutrophil cytoplasmic antibodies (ANCA) (continued)
- Other disorders associated with anti-neutrophil cytoplasmic antibodies (ANCA) (continued)
- Other disorders associated with anti-neutrophil cytoplasmic antibodies (ANCA) (continued)
- Diagnostic outcome of positive ANA tests
Summary
Putting the autoantibodies together
- Key takeaways
- Autoantibodies with the highest diagnostic value
References
Sources cited in this chapter
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- Dermatology, 5th Edition (2-Volume Set)