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Thursday, August 21, 2014
Arthritis and Rheumatism
A 49 yr. old women with several years of a highly elevated ANA low C3 suspicious for lupus. The usual complaints :fatigue, sensative to light, sicca, joint pain; especially wrist, hands, knees , ankles, back.Raynauds, mod. high BP, etc... Positive for SCL-70 anti-bodies. What other diseases besides scleroderma might include this anti-body? I have no skin involvement other then raynauds as yet. I have read some articles that have followed some lupus patience with exactly the same criteria. Neo evidence of scleroderma.
Please help me with some info.
The main point to consider in this situation is that the predictive potential for the SCL-70 antibody is very poor outside of the realm of Scleroderma. In other words, I would not use this blood test to attempt to assist with the diagnosis in any disease except for Scleroderma. The SCL-70 antibody may be present in 40% or less of individuals with Sceroderma, but its specificity for the disease is considered to be high (but not 100%).
Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University