the diagnosis of systemic lupus erythematosus (SLE) must be based on

the proper constellation of clinical findings and laboratory evidence. The

diagnosis of systemic lupus erythematosus (SLE) must be based on the
proper constellation of clinical findings and laboratory evidence.
Autoantibody tests
Autoantibody Tests for SLE 

Test Description

Screening test; sensitivity 95%; not diagnostic

ANA
without clinical features

High specificity; sensitivity only 70%; level is

Anti-dsDNA
variable based on disease activity

Most specific antibody for SLE; only 30-40%

Anti-Sm
sensitivity

Present in 15% of patients with SLE and other

Anti-SSA (Ro) or
connective-tissue diseases such as Sjögren
Anti-SSB (La)
syndrome; associated with neonatal lupus

Uncommon antibodies that may correlate with

risk for CNS disease, including increased
Anti-ribosomal P hazards of psychosis in a large inception cohort,
although the exact role in clinical diagnosis is
debated [108]

Included with anti-Sm, SSA, and SSB in the

ENA profile; may indicate mixed connective-
Anti-RNP
tissue disease with overlap SLE, scleroderma,
and myositis
 IgG/IgM variants measured with ELISA are
among the antiphospholipid antibodies used to
Anticardiolipin
screen for antiphospholipid antibody syndrome
and pertinent in SLE diagnosis

Multiple tests (eg, direct Russell viper venom

Lupus
test) to screen for inhibitors in the clotting
anticoagulant
cascade in antiphospholipid antibody syndrome

Direct Coombs Coombs test–positive anemia to denote

test antibodies on RBCs

Drug-induced lupus ANA antibodies are often of

this type (eg, with procainamide or hydralazine;
Anti-histone
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. In June 2022 the US Food
and Drug Administration (FDA) cleared the EliA Rib-P test (Thermo Fisher
Scientific, Waltham MA), a fluorescence enzyme immunoassay (FEIA) for
anti–ribosomal P antibodies. [109]

These autoantibodies have high specificity for SLE, and detection of them can
 

support the diagnosis of SLE, particularly in ANA- negative patients.

https://emedicine.medscape.com/article/332244-workup?
icd=ssl_login_success_221007#c8Systemic lupus erythematosus (SLE) is an
autoimmune disorder characterized by antibodies to nuclear and cytoplasmic
antigens, multisystem inflammation, protean clinical manifestations, and a
relapsing and remitting course. More than 90% of cases of SLE occur in
women, frequently starting at childbearing age. See the image below.
Sensitivity: the ability of a test to correctly identify patients with a disease. Specificity:
the ability of a test to correctly identify people without the disease