Among the systemic sclerosis-specific autoantibodies, which one is associated with diffuse cutaneous disease, a heightened risk of scleroderma renal crisis even at normal baseline blood pressure, and an increased frequency of concurrent malignancy within two years of disease onset?

• A Anti-RNA polymerase III ✓
• B Anti-topoisomerase I (anti-Scl-70)
• C Anti-centromere antibody
• D Anti-U3 RNP (fibrillarin)

Explanation

Anti-RNA polymerase III antibodies define a diffuse cutaneous subset with rapid skin thickening and a disproportionate risk of hypertensive renal crisis, which can precede any blood pressure rise. This antibody is also linked to de novo solid malignancies diagnosed close to the onset of scleroderma. Anti-topoisomerase I predicts interstitial lung disease rather than renal crisis, anti-centromere marks limited disease with pulmonary hypertension, and anti-fibrillarin associates with internal organ involvement and poor prognosis.

Reference: Firestein: Kelley and Firestein's Textbook of Rheumatology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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