While the anti-Sm
antibodies are known for being extremely specific to lupus, a diagnosis should not be made based solely on a single test result taken in isolation.
Patient Reference Test result interval Lupus anticoagulant test DRVVT, seconds 65.5 33-44 DRVVT mix, seconds 63.2 33-44 DRVVT confirmation, screen/ 1.70 0.00-1.20 confirmation Prothrombin time, seconds 12.6 10.0-14.0 APTT, seconds 33.5 22.8-35.0 Thrombin time, seconds 15.9 14.0-21.0 APS antibody test Anticardiolipin antibody Negative Negative Anti-[beta]2 glycoprotein I Negative Negative antibody Autoimmune antibody panel Antinuclear antibody (ANA) Positive Negative Anti-dsDNA Positive Negative Antihistones Positive Negative Anti-Sm
Positive Negative Anti-snRNP70 Positive Negative SS-A(Ro) Positive Negative SS-B(La) Negative Negative Anti-Scl-70 Negative Negative Anticentromere Negative Negative Jo-1 Negative Negative Table 2.
In the following months after surgery, 4 of the 11 American College of Rheumatology criteria required for the diagnosis of SLE; ANA positivity, oral ulcers, photosensitivity and immunological disorder presenting with anti-Sm
antibody positivity were documented.9 It is a rare finding in SLE to have a vaginal ulcerous lesion.10 We hypothesized that the asymptomatic vaginal ulcer could have caused a chronic inflammatory process eventually resulting in labial adhesion.
For example, the presence of anti-ribonucleoprotein (RNP) antibodies is part of the diagnosis of mixed connective tissue disease (MCTD), and positive results for ANA and the presence of anti-dsDNA or anti-Sm
constitute three of the six immunological criteria for the diagnosis of systemic lupus erythematosus (SLE) [16, 17].
Some studies did not find any correlation of IL23 with autoantibodies typical for lupus like anti-double stranded DNA or anti-Sm
The ANA (1/100), anti-dsDNA, and anti-SSA were positive, but anti-Sm
The immunological markers, including anti-Ro/SSA, anti-LA/SSB, anti-DNA, antinuclear antibody, anti-cardiolipin antibody, anti-Sm
, U1-RNP, Jo-1 and Scl7O, of both infants and the mother were found to be negative.
Disease Predictive evolution factors Clinical Serological Systemic Lupus Serositis Anti-dsDNA Erythematosus (SLE) Alopecia Anti-Sm
Photosensitivity Antiphospholipid Discoid rash Sjogren Syndrome (SS) Raynaud Anti-Ro Xerostomia Anti-La Systemic Sclerosis (Scl) Raynaud ANA nucleolar Sclerodactyly pattern Esophageal dysfunction Rheumatoid Arthritis (RA) Polyarthritis Rheumatoid factor Table 2: Classical clinical associations of anti-Ro52 antibodies.
Parameter Patient value Reference value Anti-TPO (CSF) 11.96 0-5.61 UI/ML Anti-dsDNA/ANA Negative Negative Anti-SM
and anti-Ro/SSA Negative Negative cANCA 1.12 U/mL 0.00-5.00 Anti-NMDA Negative Negative RF 3.70 <15 UI/mL IgE 333 0.00-100 mg/dL IgA 1607 70-400 mg/dL IgM 340 40-240 mg/dL CPK 45 26-170 U/L Anti-TPO: thyroid peroxidase antibodies; CSF: cerebrospinal fluid; anti- DNA: anti-DNA double strand; ANA: antinuclear autoantibodies; anti- SM: anti-Smith; anti-RO/SSA: anti-Sjogren-syndrome-related antigen A; cANCA: cytoplasmic antineutrophil antibodies; anti-NMDA: anti-N-methyl D-aspartate receptor antibodies; RF: rheumatoid factor; Ig: immunoglobulin; CPK: creatine phosphokinase.
The anti-SmD1[sub]83-119 antibody has exhibited higher sensitivity and specificity than anti-Sm
antibody in diagnosing adult SLE.
Anticardiolipin immunoglobulin (Ig)-G and IgM antibodies, lupus anticoagulant, anti-Ro, anti-La, anti-Sm
antibodies, and the venereal disease research laboratory (VDRL) test were negative.