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1 LL - LL-ROHINI (NATIONAL REFERENCE Age 25 Years Gender Male 30/8/ AM 30/8/ AM 31/8/ AM Ref By Final COLLAGEN DISEASES ANTIBODY ANEL ANTI NUCLEAR ANTIBODY / FACTOR (ANA/ANF), SERUM Moderate positive >60 Strong positive Units <20.00 Antinuclear antibodies are the most sensitive screening test for autoantibodies in patients suspected of connective tissue diseases. They are a heterogenous group of autoantibodies directed against ds-dna, histones, SSA / Ro, SSB / La, Sm, Sm / RN, Scl-70, Jo-1 & Centromere. ANA s have also been detected in patients with Autoimmune Hepatitis (80%),rimary biliary cirrhosis (60%), Alcohol related liver disease (50%), Viral hepatitis B (40%). resence of ANA has also been detected in individuals taking certain drugs like Hydrallazine, Isoniazid, Chlorpromazine; family of SLE patients; healthy and elderly persons ANTI - ds DNA ANTIBODY, SERUM -- RESULT IN IU/mL REMARKS <30 Negative Equivocal >75 ositive IU/mL <30.00 Anti double stranded DNA (ds DNA) antibodies are specific for SLE observed in 40-90% of these patients with active disease. American Rheumatoid arthritis association considers the presence of ds-dna antibody as a diagnostic criteria for SLE. These antibodies are directly involved in the disease process being deposited as DNA / Anti DNA immune complexes. This test is used for diagnosis and monitoring of SLE with atientreportscsuperanel.s_general_temlate01_sc (Version 7) age 1 of 6

2 LL - LL-ROHINI (NATIONAL REFERENCE Age 25 Years Gender Male 30/8/ AM 30/8/ AM 31/8/ AM Ref By Final high levels being associated with exacerbation of disease activity and lower levels correlating with remission. They may be raised in patients with Discoid lupus erythematosus. All SLE patients may not show elevated ds-dna antibodies especially those at the peak of SLE exacerbation. In some cases the level may remain elevated even during the remission phase of the disease. CENTROMERE ANTIBODY, SERUM Weak ositive >30 Strong ositive 3.00 Units <20.00 Centromere antibodies are associated with Scleroderma, a multisystem connective tissue disorder with vascular lesions and tissue fibrosis. atients with Systemic Sclerosis spontaneously produce autoantibodies against nuclear, nucleolar and mitochondrial antigens which are of diagnostic and prognostic significance. Autoantibodies to centromere proteins are present in 50-80% CREST subset; 25% patients with idiopathic Raynaud s phenomenon and 8% with diffuse form of the disease. Centromere antibodies are most often associated with lower frequency of pulmonary fibrosis and mortality although an increased risk for pulmonary hypertension has been observed. Jo-1 ANTIBODY, SERUM Weak positive ositive >80 Strong ositive Units <20.00 atients suffering from idiopathic inflammatory myopathies commonly show myositis associated antibodies atientreportscsuperanel.s_general_temlate01_sc (Version 7) age 2 of 6

3 LL - LL-ROHINI (NATIONAL REFERENCE Age 25 Years Gender Male 30/8/ AM 30/8/ AM 31/8/ AM Ref By Final directed against histidyl-trna synthetase / Jo-1 antigen. revalence of Jo-1 antibodies Disease revalence rimary polymyositis 33% rimary dermatomyositis 25% Myositis in association with 15% other connective tissue diseases The serum levels of Jo-1 antibodies vary depending on the activity of the disease. Jo-1 antibodies are detected months before the outbreak of myositis suggesting a marker function for this antibody. Over 70% of patients with a positive result show signs of fibrosing alveolitis, polyarthritis, occasionally Raynaud s phenomenon or other signs of Scleroderma. Scl-70 (SCLERODERMA ) ANTIBODY, SERUM Weak ositive Moderate ositive >80 Strong ositive Units <20.00 Antibodies to Scl-70 (DNA topoisomerase I) are detected in nearly 75% patients with rogressive Systemic Sclerosis (SS). These antibodies can also be detected in 20-59% patients of connective tissue disorders and 13% patients with CREST syndrome. atients of Scleroderma with Scl-70 antibody positivity are associated with diffuse cutaneous involvement, increased frequency of pulmonary fibrosis and high mortality. Sm (SMITH), ANTIBODY, IgG, SERUM Units <20.00 atientreportscsuperanel.s_general_temlate01_sc (Version 7) age 3 of 6

4 LL - LL-ROHINI (NATIONAL REFERENCE Age 25 Years Gender Male 30/8/ AM 30/8/ AM 31/8/ AM Ref By Final Weak ositive Moderate ositive >80 Strong ositive Antibodies to Smith antigen are considered a highly specific marker for SLE. They usually occur in association with nuclear Ribonuclear proteins (nrn). SLE patients with presence of Anti Sm antibodies usually have associated renal disease and / or disorders of central nervous system. SSA/Ro ANTIBODY, SERUM Weak ositive Moderate ositive >80 Strong ositive Units <20.00 atients with SLE may have antibodies to SSA/Ro alone or may have both SSA/Ro & SSB/La antibodies. resence of SSA/Ro antibody alone is commonly seen in association with HLA DR2 in patients less than 22 years of age at onset. resence of both SSA/Ro & SSB/La in SLE is associated with HLA DR3 and is seen in older patients more than 50 years of age at onset. SLE patients with SSA/Ro antibodies develop a much more serious renal disease and have a higher incidence of concomitant Anti DNA antibodies. Increased levels Subacute cutaneous Lupus erythematosus Neonatal Lupus erythematosus syndrome with congenital heart block and cutaneous lesions Homozygous C2 & C4 deficiency with SLE like disease rimary Sjogren s syndrome vasculitis, Rheumatoid factor positivity & severe systemic symptoms ANA negative SLE patients atientreportscsuperanel.s_general_temlate01_sc (Version 7) age 4 of 6

5 LL - LL-ROHINI (NATIONAL REFERENCE Age 25 Years Gender Male 30/8/ AM 30/8/ AM 31/8/ AM Ref By Final SLE with Interstitial pneumonitis SSB/La ANTIBODY, SERUM Weak ositive Moderate ositive >80 Strong ositive 6.00 Units <20.00 SSB/La antibodies are primarily considered as a serological marker of rimary Sjogren s syndrome and are detected in nearly 90% of these patients. They are also seen in 6-15% cases of ANA positive SLE patients. resence of both SSB / La & SSA/Ro antibodies in SLE patients shows a lower incidence of renal disease and lower levels of concomitant Anti DNA antibodies. Detection of this antibody can precede the development of symptoms of Sicca syndrome by several years. U1RN ANTIBODIES, SERUM - RESULT IN Units REMARKS Weak ositive Moderately ositive >80 Strong ositive Units <20.00 Antibodies to both Sm (Smith) & nuclear ribonuclear proteins(nrn) are found in patients with SLE. When Anti RN antibodies are found in higher titers in patients sera, usually in the absence of Anti smith antibodies, they are associated with Mixed Connective Tissue Disease (MCTD). SLE patients who have antibodies to only nrn have a lower frequency of DNA antibodies and lower incidence of clinically apparent renal disease. age 5 of 6 atientreportscsuperanel.s_general_temlate01_sc (Version 7)

6 LL - LL-ROHINI (NATIONAL REFERENCE Age 25 Years Gender Male 30/8/ AM 30/8/ AM 31/8/ AM Ref By Final Dr. Ritu Nayar MD (Microbiology) Deputy HOD Microbiology & Serology Dr. Shalabh Malik MD (Microbiology) National Head - Microbiology & Serology End of report atientreportscsuperanel.s_general_temlate01_sc (Version 7) age 6 of 6

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