Immunopathology

For each of the following descriptions, select the most likely serologic test:

1. A 31-year-old woman has a malar rash that worsens when she has been outdoors. She has arthralgias without joint deformity or swelling. She has a urinalysis that shows 4+ blood and RBC casts. A renal biopsy shows 'wire loop' lesions of the glomeruli:

2. A 29-year-old woman has severe myalgias for over a month. Her serum creatine kinase is 1120 U/L. She does not have arthralgias or skin rash:

3. A 49-year-old woman with atrophic gastritis has a CBC that shows WBC count 5460/microliter, Hgb 10.8 g/dL, Hct 33.2%, MCV 121 fL, and platelet count 133,000/microliter:

4. A 26-year-old primagravida has a history of recurrent thrombosis. She has an ultrasound performed at 18 weeks gestation that reveals normal fetal development. However, at 32 weeks she notes absence of fetal movement for a day. The fetus is stillborn several days later:

5. A 41-year-old man has had malaise for several months. During this time he has had myalgias with a serum creatine kinase of 402 U/L. He has skin rashes on sun exposed areas of his body. His fingers become cold and blue upon exposure to cold. He has had bilateral swelling and pain of the small joints of his hands:

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A. ANA, nucleolar pattern B. ANA, rim pattern C. ANA, speckled pattern D. ANA titer 1:16 E. Anti-centromere
F. Anti-dsDNA G. Anti histone H. Anti-mitochondrial I. Anti-parietal cell J. Anti-phospholipid antibody
K. Anti-Smith L. Anti-thyroglobulin M. HLA-DR4 N. HLA-B27 O. Jo-1
P. Rheumatoid factor, titer 1:1280 Q. Ribonucleoprotein R. Scl-70 S. SS-A T. SS-B
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