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Serology

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Autoantibodies:

  • antibodies to double stranded DNA and the antinuclear antibody anti-Sm, are highly specific for SLE but are poor "markers" because of their low prevalences, 50-70% and 7-30%
  • anti-Ro and anti-La antinuclear antibodies occur in both SLE and Sjogren's syndrome
  • anti-Ro is important in pregnancy since it is associated with babies born with congenital heart block
  • anti U1 ribonucleoprotein, formerly, anti-RNP, is not specific for SLE
  • anti-histone antibodies indicate drug induced SLE
  • anti-cardiolipin is associated with thrombosis (arterial or venous), chorea, and livedo reticularis

Lupus anticoagulant in 30% of cases - with prolonged PTT and false-positive VDRL test for syphilis.

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