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Logo of arthrestherBioMed Centralbiomed central web sitesearchsubmit a manuscriptregisterthis articleArthritis Research & Therapy
 
Arthritis Res Ther. 2003; 5(2): 80–93.
Published online Feb 12, 2003.
PMCID: PMC165038
The clinical relevance of autoantibodies in scleroderma
Khanh T Ho1 and John D Reveillecorresponding author1
1Division of Rheumatology and Clinical Immunogenetics and General Medicine, The University of Texas-Houston Health Science Center (UTH-HSC), Houston, Texas, USA
corresponding authorCorresponding author.
John D Reveille: john.d.reveille/at/uth.tmc.edu
Received November 14, 2002; Revised January 14, 2003; Accepted January 17, 2003.
Abstract
Scleroderma (systemic sclerosis) is associated with several autoantibodies, each of which is useful in the diagnosis of affected patients and in determining their prognosis. Anti-centromere antibodies (ACA) and anti-Scl-70 antibodies are very useful in distinguishing patients with systemic sclerosis (SSc) from healthy controls, from patients with other connective tissue disease, and from unaffected family members. Whereas ACA often predict a limited skin involvement and the absence of pulmonary involvement, the presence of anti-Scl-70 antibodies increases the risk for diffuse skin involvement and scleroderma lung disease. Anti-fibrillarin autoantibodies (which share significant serologic overlap with anti-U3-ribonucleoprotein antibodies) and anti-RNA-polymerase autoantibodies occur less frequently and are also predictive of diffuse skin involvement and systemic disease. Anti-Th/To and PM-Scl, in contrast, are associated with limited skin disease, but anti-Th/To might be a marker for the development of pulmonary hypertension. Other autoantibodies against extractable nuclear antigens have less specificity for SSc, including anti-Ro, which is a risk factor for sicca symptoms in patients with SSc, and anti-U1-ribonucleoprotein, which in high titer is seen in patients with SSc/systemic lupus erythematosus/polymyositis overlap syndromes. Limited reports of other autoantibodies (anti-Ku, antiphospholipid) have not established them as being clinically useful in following patients with SSc.
Keywords: anti-centromere, anti-Scl-70, autoantibodies, scleroderma, systemic sclerosis
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