Medicine · Rheumatology (SLE, RA, Vasculitis, Crystal Arthropathies, Scleroderma)

A 38-year-old woman presents with malar rash, photosensitivity, arthritis, and oral ulcers. Per the 2019 ACR/EULAR classification criteria for SLE, which autoantibody serves as the entry criterion for classification?

  • A Anti-Smith (anti-Sm) antibody
  • B Anti-double-stranded DNA (anti-dsDNA) antibody
  • C Antinuclear antibody (ANA) at a titer of 1:80 or higher
  • D Anti-Ro (SSA) antibody
Correct answer: C. Antinuclear antibody (ANA) at a titer of 1:80 or higher

Explanation

The 2019 ACR/EULAR SLE classification criteria require a positive ANA at a titer of 1:80 or higher as the entry criterion before weighted additive clinical and immunological criteria are applied. Anti-dsDNA and anti-Sm are weighted criteria within the classification but do not serve as the entry gate. This structure prevents overdiagnosis in ANA-negative individuals.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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