Extractable nuclear antigens (ENA)
- some patients are antinuclear antibody (ANA) positive but have antibodies which recognise different sets of nuclear proteins, termed extractable nuclear antigens (ENA)
- commonest is anti-Ro which is usually clinically associated with photosensitivity
- ENA antibodies
- RNP may occur in SLE, scleroderma and 'overlap' connective tissue disease
- Sm may occur in SLE (associated with risk of renal disease)
- Ro, La may occur in SLE and Sjögren's (associated with photosensitivity and neonatal heartblock)
- centromere may occur in limited cutaneous systemic sclerosis (SS)
- Scl-70 may occur in diffuse cutaneous SS
- Cardiolipin may occur in SLE and antiphospholipid syndrome (arterial and venous thromboses, mid-trimester foetal loss)
Reference:
- ARC. Connective tissue disease in primary care. Hands On 2006; 9:1-5.
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