TEST

INDICATIONS

INTERPRETATION

• Suspected connective tissue disease or any inflammatory disease.

• Speckled - Suggestive of a CTD
• Homogeneous - Suggestive of SLE , RA or drug
• Rim - Suggestive of SLE
• Centromere - Suggestive of Scleroderma
• Nucleolar - Suggestive of Sjogren’s syndrome or Scleroderma

In adults titres <1:160 are less likely to be clinically significant

• SLE diagnosis and monitoring disease activity

• If substantially elevated diagnostic of active SLE
• If normal, SLE not excluded
• Change in titre relates to disease activity

• Categorisation of ANA
• Diagnosis of ANA-negative CTD

• RNP alone in high titre - suggests MCTD
• SSA/SSB (Ro/La) - suggests Sjogren's syndrome
• SSA (Ro) - SLE subset
• Sm - specific for SLE
• Jo-1 - suggests Polymyositis
• Scl 70 - suggests Scleroderma

• Suspicion of RA or other CTD

• Suggestive of RA or Sjogen’s syndrome
• NOT diagnostic of RA

• Recurrent mid trimester  abortions
• Arterial or venous thromboembolic disease
• Assessment for risk in SLE
• Thrombocytopaenia

• Risk of arterial and venous thromboembolism, recurrent abortions, with or without SLE
• In SLE also associated with CNS disease and thrombocytopaenia

• Recurrent mid trimester  abortions
• Arterial or venous thromboembolic disease
• Assessment for risk in SLE
• Thrombocytopaenia

• As for cardiolipin antibody but thought to be more specific.

• Vasculitis

• cANCA with PR3 Ab - highly specific for Wegener's Granulomatosis or microscopic PAN
• pANCA often with Ab to MPO - poor specifcity but associated with nephritis or vasculitis.

• Chronic liver disease

• GPC Ab in high titre unusual other than with primary biliary cirrhosis
• Mitochondrial Ab subtyping can provide additional diagnostic and prognostic information.

• Chronic liver disease

• Low titre common finding
• High titre seen frequently in autoimmune chronic active hepatitis

• Autoimmune cause for thyroid disease
• Predisposition to autoimmune thyroid disease

• In high titre, combination of these Ab's detects almost all cases of autoimmune thyroid disease

• Diagnosis of thyrotoxicosis
• Assessment of disease remission

• Elevated only in thyrotoxicosis
• Normalisation predicts remission

• Suspected Addison's disease

• Addison's disease

• Bullous skin disease

• Intercellular cement pemphigus
• Basement membrane-pemphigoid
• Basement membrane IgA Ab - dermatitis herpetiformis

• Suspected pernicious anaemia
• Thyrogastric autoimmunity

• Atrophic Gastritis
• Necessary but not specific for pernicious anaemia of immune aetiology

• Coeliac disease

• IgA gliadin antibody associated with coeliac disease
• Moderate specificity
• Test not interpretatable in IgA deficiency

• Coeliac disease

• Highly associated with coeliac disease
• Test not interpretable in presence of IgA deficiency

• Myasthenia Gravis

• When present, is diagnostic of myasthenia gravis
• Titre related to disease activity

• Pulmonary haemorrhage
• Glomerulonephritis

• Goodpasture's Syndrome