A number of immunology tests are available to GPs. A positive test is significant only if the individual has symptoms.
|
Symptoms |
Tests to consider doing |
Likely Rheumatic Condition |
Comment |
|---|---|---|---|
|
Inflammatory joint symptoms
|
CCP |
Rheumatoid arthritis |
|
|
ENA Rheumatoid factor |
Sjogren’s Syndrome |
Antibodies to Ro and La often observed in Sjogren’s |
|
ANA ENA |
Dermatomyositis / polymyositis |
|
|
ANA ENA |
Lupus |
|
|
ENA ANA |
Systemic Sclerosis |
Inflammatory markers often normal |
|
Lupus anticoagulant & anticardiolipin antibodies |
Antiphospholipid syndrome |
Haematology |
|
ANCA |
Systemic Vasculitis |
Inflammatory markers raised |
M.A & H.B/S.R 29-7-26
Antibody testing should not be used as a screening test for rheumatological disorders. A good history will guide the tests undertaken. These conditions are managed by various specialities and symptoms/signs will also direct referral.
Who to refer:
Only patients who have symptoms suggestive of an autoimmune inflammatory disorder
If patient has clinical symptoms of an inflammatory arthritis, please refer straightaway instead of waiting for immunology
Who not to refer:
A patient with a positive ANA without symptoms should NOT be referred to Rheumatology
How to refer:
- SCI Gateway > Rheumatology > WGH
- If patient is systemically unwell with suspected lupus, myositis, vasculitis please discuss with the Rheumatology oncall team
