The diagnosis of @entity32 rests on a constellation of symptoms, signs, laboratory test results and, occasionally, histological findings. Classification criteria have been developed by national learned societies, international panels of experts or, more rarely, an expert working alone. These criteria are intended to provide a common language for therapeutic trials and international publications. Yet, they are often inappropriately used as diagnostic tools for the individual @entity1 . Identification of an early seroimmunologic marker with high sensitivity and specificity for classifying @entity1 with recent-onset @entity2720 is a daunting challenge. Test performance characteristics such as sensitivity, specificity, positive and negative predictive values, and the positive or negative likelihood ratio help to assess the diagnostic usefulness of a laboratory test in a specific situation. The difference between the pretest and posttest likelihoods of obtaining a positive or negative result measures the usefulness, or performance, of a laboratory test in a specific situation according to the prevalence of the disease. A higher positive likelihood ratio indicates a more useful test. In a @entity1 with @entity32 , the diagnosis can be sought by assaying a limited number of autoantibodies according to a decision tree. Thus, IgM rheumatoid factors (latex test or ELISA) and antibodies to filaggrin or other citrullinated proteins (antikeratin antibodies by indirect immunofluorescent assay or anticyclic citrullinated peptides by ELISA) identify more than 70% of cases of early @entity309 with greater than 98% specificity. If these markers are negative, testing for antinuclear antibodies by indirect immunofluorescent assay on HEp-2 cells identifies 99% of cases of @entity1252 and progressive @entity785 . Confirmation of the diagnosis can be obtained by characterizing the autoantibodies: thus, presence of antidouble-stranded DNA (dsDNA, by the Farr radioimmunoassay, indirect immunofluorescent assay on Crithidia luciliae, or ELISA (IgG)) or of antinucleosome antibodies (ELISA) indicates @entity1252 , whereas anticentromere, antitopoisomerase I (Scl 70), and antinucleolar antibodies point to progressive @entity785 . A positive test for antibodies to soluble nuclear antigens of the @entity8107 type suggests mixed connective tissue disease or @entity1252 but may indicate @entity2631 . Anti-Sm antibodies are found in fewer than 10% of @entity1252 @entity1 but are highly specific. Anti-SSA (Ro) and anti-SSB (La) suggest @entity1252 or primary Sj  gren's syndrome. When tests are negative for ANA, several antibodies to cytoplasmic organelles are valuable diagnostic tools, such as anti-J01 for @entity6558 syndromes and antiribosome antibodies for @entity1252 , although their sensitivity is modest (20-25%). Finally antineutrophil cytoplasmic antibodies (ANCAs) ensure the diagnosis of @entity6249 , which often involve the lungs and kidneys. Thus, in diffuse @entity2883 , ANCAs exhibiting the classic cytoplasmic pattern and corresponding by ELISA to anti- @entity7134 are found. In @entity6129 the ANCAs are peripheral and correspond by ELISA to antimyeloperoxidase antibodies. Tests for other antibodies are less often needed to evaluate @entity32 .

Evaluating XXXX : how and when can autoantibodies help?

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity32 :: ('MESH:D007249', 'Disease') :: ['inflammatory joint disease'] @entity6249 :: ('MESH:D059345', 'Disease') :: ['small-vessel vasculitides'] @entity1252 :: ('MESH:D008180', 'Disease') :: ['lupus'] @entity8107 :: ('6625', 'Gene') :: ['U1 RNP'] @entity2631 :: ('MESH:D012594', 'Disease') :: ['scleroderma'] @entity6129 :: ('MESH:D055953', 'Disease') :: ['microscopic polyangiitis'] @entity6558 :: ('MESH:D017285', 'Disease') :: ['polymyositis'] @entity2883 :: ('MESH:D014890', 'Disease') :: ["Wegener's granulomatosis"] @entity2720 :: ('MESH:D007592', 'Disease') :: ['joint disease'] @entity309 :: ('MESH:D001172', 'Disease') :: ['rheumatoid arthritis'] @entity7134 :: ('5657', 'Gene') :: ['PR3'] @entity785 :: ('MESH:D012595', 'Disease') :: ['systemic sclerosis']
@entity32 :: (MESH:D007249,Disease) :: ['inflammatory joint disease']
