A 27-year-old female presents to the emergency room with a temperature of 103degF, severe fatigue, weight loss, and joint pain. During the history and physical examination, the patient reports that she stopped taking her aspirin and corticosteroids to control her condition. A butterfly-type rash over her cheeks, sensitivity to light, and a heart murmur are apparent. The patient also reports a history of a progressively developing arthritis and glomerulonephritis. Laboratory tests further indicate anemia, leukopenia, and thrombocytopenia. This condition is best diagnosed by the presence of which of the following?
This clinical case represents a patient suffering with SLE. The diagnosis of SLE is best supported by detecting the presence of anti-dsDNA and anti-Smith (anti-Sm) antibodies. The presence of anti-dsDNA antibodies are very specific for SLE and represent a poor prognosis for disease. Antinuclear antibodies (ANA) can also be detected using fluorescent antibody tests. The other antibodies listed are related to other autoimmune diseases as follows: anticentromere antibodies in CREST syndrome and occasionally in systemic scleroderma, antimitochondrial antibodies in primary biliary cirrhosis, antineutrophil antibodies in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (systemic vasculitis), and anti-TSH receptor antibodies in Graves' disease (hyperthyroidism).
Anticentromere antibodies
Anti-dsDNA antibodies
Antimitochondrial antibodies
Antineutrophil antibodies
Immunology