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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