In a 30 years old female patient with polyahritis, testing reveals nucleolar pattern of ANA staining. What is the likely course of this patient?
(A) Malar rash, alopecia and renal failure (B) Sclerodactyly, esophageal dysmotility and Raynaud's phenomenon (C) Sjogren's syndrome (D) Painful genital and oral blisters and ulcers
(B) Answer- B. Sclerodactyly, esophageal dysmotility and Raynaud's phenomenonNucleolsr ANA positivity is most likely suggestive of systemic sclerosis or scleroderma, which comprises of diffuse or limited disease-CREST syndrome (Calcinosis, Raynaud syndrome, Esophageal dysmotility, Sclerodactyly, Telangiectasia)Antinuclear antibodies are directed against nuclear antigens, grouped into: ( I ) antibodies to DNA (2) antibodies to histones (3) antibodies to non-histone proteins bound to RNA (4) antibodies to nucleolar antigens.Most widely used method for detecting ANAs: Indirect immunoffuorescence (identify antibodies that bind to a variety of nuclear antigens, including DNA, RNA & proteins).Pattern of nuclear fluorescence suggests the type of antibody present in the patient's serum.