Which autoantibody tests are used in the diagnosis of systemic lupus erythematosus (SLE)?

Updated: Aug 04, 2021
  • Author: Christie M Bartels, MD, MS; Chief Editor: Herbert S Diamond, MD  more...
  • Print
Answer

Table 3, below, summarizes the autoantibody tests that are used in the diagnosis of SLE. [103]

Table 3. Autoantibody Tests for SLE (Open Table in a new window)

Test

Description

ANA

Screening test; sensitivity 95%; not diagnostic without clinical features

Anti-dsDNA

High specificity; sensitivity only 70%; level is variable based on disease activity

Anti-Sm

Most specific antibody for SLE; only 30-40% sensitivity

Anti-SSA (Ro) or Anti-SSB (La)

Present in 15% of patients with SLE and other connective-tissue diseases such as Sjögren syndrome; associated with neonatal lupus

Anti-ribosomal P

Uncommon antibodies that may correlate with risk for CNS disease, including increased hazards of psychosis in a large inception cohort, although the exact role in clinical diagnosis is debated [104]

Anti-RNP

Included with anti-Sm, SSA, and SSB in the ENA profile; may indicate mixed connective-tissue disease with overlap SLE, scleroderma, and myositis

Anticardiolipin

IgG/IgM variants measured with ELISA are among the antiphospholipid antibodies used to screen for antiphospholipid antibody syndrome and pertinent in SLE diagnosis

Lupus anticoagulant

Multiple tests (eg, direct Russell viper venom test) to screen for inhibitors in the clotting cascade in antiphospholipid antibody syndrome

Direct Coombs test

Coombs test–positive anemia to denote antibodies on RBCs

Anti-histone

Drug-induced lupus ANA antibodies are often of this type (eg, with procainamide or hydralazine; p-ANCA–positive in minocycline-induced drug-induced lupus)

ANA = antinuclear antibody; CNS = central nervous system; ds-DNA = double-stranded DNA; ELISA = enzyme-linked immunoassay; ENA = extractable nuclear antigen; Ig = immunoglobulin; p-ANCA = perinuclear antineutrophil cytoplasmic antibody; RBCs = red blood cells; RNP = ribonucleic protein; SLE = systemic lupus erythematosus; Sm = Smith; SSA = Sjögren syndrome A; SSB = Sjögren syndrome B.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!