Rheum| Antibody Review Step 1 Basics (USMLE)

4.11 Antibody Review
Rheumatology review for the USMLE Step 1 Exam.
ANA Principles
ANA (Anti-Nuclear Antibody): Non-specific antibody. Reacts against nuclear antigens, including proteins, DNA, RNA, and nucleic acid-protein complexes. Includes a group of antibodies such as anti-dsDNA, anti-histone, SSA/Ro, SSB/La, Scl-70, anti-aminoacyl-tRNA synthetase (Jo-1). Found in 20-30% of the general public without connective tissue disorder symptoms. ANA+ individuals may or may not have a rheumatologic disorder. Further workup is needed in ANA+ cases to determine the specific disorder. Antibodies by Disease Process
Systemic Lupus Erythematosus (SLE)
Anti-dsDNA antibody. Anti-Smith antibody. Drug-Induced Lupus
Anti-histone antibody. Diffuse vs. Limited Scleroderma
Diffuse: Anti-Scl-70 (anti-topoisomerase I). Limited: Anti-centromere (often called CREST syndrome, with CREST standing for centromere). Sjogren's Syndrome
Anti-SSA (Ro). Anti-SSB (La), which usually occurs in the presence of SSA. SSA is considered the Sjogren-specific antibody, leading to the presence of SSB. Rheumatoid Arthritis (RA)
Anti-CCP (Cyclic Citrullinated Peptide). RF (Rheumatoid Factor) is non-specific. Thanks for listening!