Among systemic sclerosis autoantibodies, which one is most strongly associated with diffuse cutaneous disease and interstitial lung fibrosis?

• A Anti-centromere
• B Anti-U3 RNP (fibrillarin)
• C Anti-topoisomerase I (Scl-70) ✓
• D Anti-Th/To

Explanation

Anti-topoisomerase I defines a diffuse cutaneous subset with rapid skin thickening and a high frequency of fibrosing interstitial lung disease; it also correlates with poorer survival. Anti-centromere marks limited cutaneous disease with pulmonary hypertension rather than fibrosis. Anti-fibrillarin and anti-Th/To associate with pulmonary hypertension and limited disease respectively, making them weaker fits for this phenotype.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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