Different antibodies have different disease associations
| Antibody | Disease association | Nota bene |
|---|---|---|
| Rheumatoid factor (RF) | Positive in Sjögren syndrome (≤ 100%), Felty’s syndrome (≤ 100%), rheumatoid arthritis (70%), mixed connective tissue disease (50%), hepatitis and infective endocarditis (<50%), SLE (≤ 40%), systemic sclerosis (30%), normal (2 – 10%) | |
| Anti-cyclic citrullinated peptide antibodies (anti-CCP) | Positive in rheumatoid arthritis (~ 96%) | Can be used for the initial workup of suspected rheumatoid arthritis |
| Anti-nuclear antibody (ANA) | Positive in Sjorgen syndrome (≤ 100%), Felty’s syndrome (≤ 100%), rheumatoid arthritis (70%), mixed connective tissue disease (50%), hepatitis and infective endocarditis (<50%), SLE (≤ 40%), systemic sclerosis (30%), normal (2 – 10%) | Positive in SLE (>95%), systemic sclerosis (96%), autoimmune hepatitis (75%), rheumatoid arthritis (30%), Sjorgens syndrome (60%), normal (0-2%) |
| ANA staining patterns | Homogenous – SLE; Nucleolar – systemic sclerosis; – Speckled – mixed connective tissue disease; Centromere – limited systemic sclerosis | This is not specific |
| Anti-double-stranded DNA (anti-dsDNA) | SLE | 60% sensitivity but highly specific |
| Anti-histone antibodies | Drug-induced SLE (100%) | |
| Anti-phospholipid antibodies | Antiphospholipid syndrome, SLE | 1:160 means antibodies can still be detected even after the serum has been diluted 160-fold. |
| Anti-centrome | Limited systemic sclerosis | |
| Anti-extractable nuclear antigen (ENA) antibodies | Anti-Ro (SSA) – SLE, Sjogren syndrome, systemic sclerosis, congenital heart block; Anti-La (SSB) – Sjogren syndrome, SLE; Anti-Sm – SLE, Anti-RNP – SLE, mixed connective tissue disease; Anti-Jo-1 and anti-Mi-2 – polymyositis, dermatomyositis; Anti-Scl70 – diffuse systemic sclerosis | Ordered after a positive ANA |
| Anti-mitochondrial antibodies | Primary biliary cholangitis (>95%), autoimmune hepatitis (30%), idiopathic cirrhosis (25-30%) | |
| Anti-smooth muscle antibodies | Autoimmune hepatitis (70%), primary biliary cholangitis (50%), idiopathic cirrhosis (25-30%) | |
| Gastric parietal cell antibodies | Pernicious anaemia (> 90%), atrophic gastritis (40%), normal (10%) | |
| Intrinsic factor antibodies | Pernicious anaemia (50%) | |
| α-gliadin antibodies | Coeliac disease | |
| Anti-tissue transglutaminase antibodies | Coeliac disease | |
| Anti-endomysial antibodies | Coeliac disease | |
| Thyroid peroxidase antibodies (anti-TPO) | Hashimoto’s thyroiditis (~ 87%), Graves’ disease (> 50%) | |
| Islet cell antibodies | Type 1 diabetes | |
| Glutamic acid decarboxylase antibodies | Type 1 diabetes | |
| Glomerular basement membrane antibodies (anti-GBM) | Goodpasture’s disease | |
| Antineutrophil cytoplasmic antibodies (ANCA) | Vasculitis, Ulcerative colitis, Crohn’s disease, sclerosing cholangitis, autoimmune hepatitis, Felty’s syndrome, rheumatoid arthritis, SLE, antithyroid drugs, allopurinol, ciprofloxacin | ANCA-associated vasculitides do not consume complement or have immune-complex deposition (pauci-immune vasculitides) |
| Cytoplasmic antineutrophilic cytoplasmic antibodies (cANCA) | Granulomatosis with polyangiitis (90%), microscopic polyangiitis (30%), polyarteritis nodosa (11%) | Specific for serine proteinase-3 (PR3 positive) |
| Perinuclear antineutrophilic cytoplasmic antibodies (pANCA) | Microscopic polyangiitis (45%), Churg-Strauss, pulmonary-renal vasculitides (Godpasture’s) | Specific for myeloperoxidase (MPO positive) |
| Acetylcholine receptor antibodies | Myasthenia gravis (90%) | |
| Anti-voltage-gated K+ channel antibodies | Limbic encephalitis | |
| Anti-voltage-gated Ca2+ channel antibodies | Lambert-Eaton syndrome | |
| Anti-aquaporin 4 antibodies | Neuromyelitis optica (Devic’s disease) |
