๐งช Antibodies to ribonucleoprotein (RNP) are often found in systemic rheumatic diseases. High titres, especially Anti-U1RNP, are a hallmark of Mixed Connective Tissue Disease (MCTD) and help differentiate it from other autoimmune conditions.
๐ About
- Types of RNP Antibodies:
- ๐งฌ RNP (Ribonucleoprotein): Autoantibodies directed against nuclear proteins bound to RNA molecules.
- ๐ฏ U1RNP: Targets U1 small nuclear ribonucleoprotein (snRNP) involved in RNA splicing โ most clinically relevant subtype.
- Association with Anti-Sm: May co-exist with Anti-Smith antibodies, particularly in SLE, giving a more complex autoimmune profile.
๐ Elevated In
- Mixed Connective Tissue Disease (MCTD):
- โ
Seen in 95โ100% of cases; virtually diagnostic when titres are high.
- ๐ Clinical overlap with lupus, scleroderma, and polymyositis.
- Features: Raynaudโs phenomenon โ๏ธ, arthritis ๐คฒ, myositis ๐ช.
- Systemic Lupus Erythematosus (SLE):
- ๐ฉบ Often present but less specific than in MCTD.
- Associated with milder disease (arthralgia, rashes) unless co-existing with Anti-Sm.
- Progressive Systemic Sclerosis (PSS):
- Occasional positivity, usually in overlap syndromes.
- โ ๏ธ Linked with pulmonary hypertension and interstitial lung disease.
๐ Clinical Significance
- ๐ฌ Diagnosis: High titres virtually define MCTD.
- ๐ Prognosis: Suggests chronic but manageable course, especially in MCTD.
- ๐ Monitoring: Serial titres sometimes used to follow activity in MCTD/SLE.
๐งช Testing
- ๐ก Indirect Immunofluorescence (ANA screen): Characteristic speckled pattern suggests RNP positivity.
- ๐งพ ELISA: Confirms and quantifies antibody levels; more specific for U1RNP.
๐ References
- UpToDate: Mixed connective tissue disease overview.
- Oxford Handbook of Rheumatology.
- ARUP Laboratory Test Directory โ Anti-U1RNP.