Evidence-based guidelines for the use of immunologic tests: anticentromere, Scl-70, and nucleolar antibodies

Evidence-based guidelines for the use of immunologic tests: anticentromere, Scl-70, and nucleolar antibodies

Evidence-based guidelines for the use of immunologic tests: anticentromere, Scl-70, and nucleolar antibodies

Introduction

The autoantibodies classically associated with systemic sclerosis (SSc; scleroderma) include anticentromere antibodies (ACA) and anti–Scl-70 (otherwise known as antitopoisomerase I or anti–topo I). In addition to these is the less-commonly occurring antinucleolar antibody system, which comprises a mutually exclusive heterogeneous group of autoantibodies that produce nucleolar staining by immunofluorescence (IIF) on cells from a variety of species (1). The most widely recognized of these include anti–PMScl (2), anti–U3-RNP (closely crossreactive with antifibrillarin) (3), anti–Th/To (4), and the anti–RNA polymerase family (RNAP), including anti–RNA polymerase I (5), II (6), and III, the latter three not always demonstrating a nucleolar staining pattern (7). The purpose of the present review is to analyze the published literature on the clinical usefulness of ordering tests of scleroderma-associated autoantibodies in patients with known or suspected scleroderma.

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