{"id":17647,"date":"2023-12-04T13:14:23","date_gmt":"2023-12-04T13:14:23","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=17647"},"modified":"2024-10-07T10:47:45","modified_gmt":"2024-10-07T09:47:45","slug":"immunology-testing-2","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/rheumatology-2\/immunology-testing-2\/","title":{"rendered":"Immunology testing"},"content":{"rendered":"\n

A number of immunology tests are available to GPs. A positive test is significant only if the individual has symptoms.<\/strong><\/p>\n\n\n

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\"Immunology
NHS Lothian<\/span><\/figcaption><\/figure>\n<\/div>\n\n\n
Symptoms<\/strong><\/td>Tests to consider<\/strong><\/td>Likely Rheumatic Condition<\/strong><\/td>Comment<\/strong><\/td><\/tr>
Inflammatory joint symptoms- pain, joint swelling, significant morning stiffness (>30-45min)<\/td>  CCP<\/td>Rheumatoid arthritis (RA)<\/td>A positive CCP may be observed in healthy individuals without joint symptoms. It is not a diagnostic test for RAA negative CCP does not exclude RA<\/td><\/tr>
Sicca symptoms arthralgia\/arthritis  <\/td>ENA Rheumatoid factor  <\/td>Sjogren\u2019s Syndrome<\/td>Antibodies to Ro and La often observed in Sjogren\u2019s<\/td><\/tr>
Muscle weaknessRaised CKSwallowing difficulty<\/td>ANA,ENA<\/td>Dermatomyositis\/polymyositis<\/td>Inflammatory markers usually raisedSignificant CK rise( see myositis page)<\/td><\/tr>
Arthritis\/arthralgiaPhotosentivityMalar rashMouth ulcersHair lossPleuritic chest pain Cytopenias  <\/td>ANA,ENA  <\/td>Lupus<\/td>A positive ANA can be seen in 30% of healthy people and is not diagnostic of SLE or other CTD. ANA should not be used to as a screening tool.<\/td><\/tr>
Secondary Raynaud\u2019s  Dyspnoea (ILD)SclerodactylyHeartburnTelangiectasia  <\/td>ENA ANA  <\/td>Systemic Sclerosis<\/td>Inflammatory markers often normal<\/td><\/tr>
Recurrent unexplained miscarriagesunexplained thromoembolic events<\/td>Lupus anticoagulant & anticardiolipin antibodies  <\/td>Antiphospholipid syndrome<\/td>Haematology<\/td><\/tr>
Generally unwellPurpuric rashProteinuriaunexplained respiratory<\/td>ANCA  <\/td>Systemic Vasculitis<\/td>Inflammatory markers raised<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

M.A & H.B\/S.R 25-01-24<\/strong><\/p>\n\n\n\n