This 53-year-old woman has pain and color changes in the digits of both hands. She reports difficulty breathing and in swallowing liquids and solids. Physical examination shows limited movement of the chest wall on inspiration. On auscultation, inspiratory crackles are heard at both lung bases. Which clinical laboratory test is MOST LIKELY to be positive?
A. Anti-double-stranded DNA antibody B. Anti-ribonucleoprotein (RNP) antibody C. Anti-Smith (Sm) antibody D. Rheumatoid factor (RF) E. Serum antinuclear antibody (ANA)
Serum antinuclear antibody (ana) -topoisomerase is the specific test but it is not given above; therefore, ana is elevated in most of the ai diseases. chronic disease characterized by: 1) chronic inflammation thought to be the result of autoimmunity 2) widespread damage to small blood vessels 3) progressive interstitial & perivascular fibrosis in skin & organs skin is most commonly affected gastrointestinal tract, kidneys, heart, muscles, & lungs also involved two major categories: 1) diffuse scleroderma -widespread skin involvement at onset - with rapid progression and early visceral involvement 2) limited scleroderma -skin involvement confined to fingers, forearms & face.occurs at 50-60 yrs, f:m 3:1 localized or generalized disease genetics hla class ii genes mutation of fibrillin-1 and other extracellular matrix protein gene associated antibodies: anti-scl70 (anti-topoisomerase i) anti-centromere antibody (crest syndrome)