Which autoantibody is specifically associated with the limited cutaneous form of systemic sclerosis (CREST syndrome) rather than diffuse systemic sclerosis?

Answer and explanation

Correct answer: C. Anti-centromere antibody

  1. Step 1: Systemic sclerosis is divided into limited cutaneous systemic sclerosis and diffuse cutaneous systemic sclerosis based on skin involvement and antibody profiles.
  2. Step 2: Anti-centromere antibodies are found in up to 70% of patients with limited systemic sclerosis (CREST syndrome: Calcinosis, Raynaud, Esophageal dysmotility, Sclerodactyly, Telangiectasia) and predict a lower risk of renal crisis.
Answer
Anti-centromere antibody.
Why not the others: Anti-Scl-70 (anti-topoisomerase I) antibodies are specific for diffuse cutaneous systemic sclerosis and associate with interstitial lung disease. Anti-RNA polymerase III antibodies are seen in diffuse disease and correlate with scleroderma renal crisis. Anti-Jo-1 antibodies are specific for polymyositis and dermatomyositis with antisynthetase syndrome.

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