Laboratory assessment in musculoskeletal disorders.
Autoimmune-mediated musculoskeletal disorders feature the presence and pathogenic role of circulating autoantibodies and autoreactive T cells. Determination of these autoantibodies provides crucial information to establish the diagnosis of these diseases. In addition, the determination of these antibodies may have prognostic value or may be used to monitor response to treatment or to predict relapse of disease. We first address the main characteristics of several autoantibody assays that are considered to be clinically most relevant. These include rheumatoid factor (RF), anti-cyclic citrullinated antibody (anti-CCP), antinuclear autoantibodies (ANA), anti-double-stranded DNA antibodies, antibodies to extractable nuclear antigens (ENA), and antineutrophil cytoplasmic autoantibodies (ANCA). Subsequently we provide a brief overview of the most important musculoskeletal disorders, such as rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome, systemic sclerosis/CREST, polymyositis/dermatomyositis and vasculitis. Our main goal was to address the role of the determination of autoantibodies in the diagnosis and follow-up of musculoskeletal disorders.
van Paassen
Pieter
P
Department of Clinical and Experimental Immunology, University Hospital, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. p.vanpassen@immuno.unimaas.nl
Damoiseaux
Jan
J
Tervaert
Jan Willem Cohen
JW
D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis; D001323:Autoantibodies / Q000032:analysis; D017675:CREST Syndrome / Q000175:diagnosis; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000276:immunology / Q000503:physiopathology; D017285:Polymyositis / Q000175:diagnosis; D011379:Prognosis; D012217:Rheumatoid Factor / Q000032:analysis; D012680:Sensitivity and Specificity; D012859:Sjogren's Syndrome / Q000175:diagnosis; D014657:Vasculitis / Q000175:diagnosis
D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; D012217:Rheumatoid Factor