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Pathology · patient case question

Which antibody profile supports the diagnosis?

Patient case: Sjögren Syndrome and Blood Pressure Screening

demo: 56-year-old female

chief: “My mouth and eyes are constantly dry.”

history: Rheumatoid arthritis. Positive anti-SSA (Ro) and anti-SSB (La) antibodies.

meds: Hydroxychloroquine

findings: Blood pressure 145/92 mmHg on two readings. Dry, atrophic oral mucosa with a lobulated tongue, generalized gingival recession, marginal gingivitis, and rampant cervical caries. Bilateral parotid enlargement. Extensive interproximal staining.

  1. Anti-desmoglein 3
  2. Anti-SSA (Ro) and anti-SSB (La)
  3. Anti-cyclic citrullinated peptide alone
  4. Anti-double-stranded DNA
Show answer and explanation

Correct answer: B. Anti-SSA (Ro) and anti-SSB (La)

  • A. Anti-desmoglein 3 antibodies are directed against desmosomes in pemphigus vulgaris.
  • B. Correct. Anti-SSA/Ro and anti-SSB/La are the serologic markers of Sjögren syndrome, alongside labial minor salivary gland biopsy showing focal lymphocytic sialadenitis.
  • C. Anti-CCP is specific for rheumatoid arthritis; it may coexist here but does not establish Sjögren syndrome.
  • D. Anti-dsDNA is highly specific for systemic lupus erythematosus.

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