Connective Tissue Disease Cascade (CTDC)

CTDC / Connective Tissue Diseases Cascade, Serum

STOP
Cyclic citrullinated Antinuclear antibodies (ANA) <3.0 U
No further testing required
peptide antibodies, IgG

≥20 U <20 U ≥3.0 U

Positive result supports the STOP

diagnosis of rheumatoid arthritis No further testing required

DNA double-stranded (dsDNA) Antibody to extractable nuclear Centromere Ribosome P

antibodies with reflex, IgG antigen evaluation antibodies, IgG antibodies, IgG
This test includes the following IgG
antibodies, which are automatically
30-75 IU/mL performed: ≥1.0 U ≥1.0 U
>75 IU/mL ■ SS-A/Ro ■ RNP

■ SS-B/La ■ Scl 70

■ Sm ■ Jo 1
Positive result supports the Positive result supports
CRITH / DNA Double-Stranded Positive result supports the diagnosis of CREST (calcinosis, the diagnosis of SLE and
(dsDNA) Antibodies by Crithidia diagnosis of systemic lupus Raynaud disease, esophageal may indicate the presence
luciliae IFA, IgG, Serum erythematosus (SLE) motility disorder, sclerodactyly, of central nervous system
and telangiectasia) syndrome involvement

Positive result Negative result

supports unable to confirm
the diagnosis borderline positive SS-A/Ro Antibodies SS-B/La Antibodies Sm Antibodies RNP Antibodies Scl 70 Antibodies Jo 1 Antibodies
of SLE result obtained
by EIA ≥1.0 U ≥1.0 U ≥1.0 U ≥1.0 U ≥1.0 U ≥1.0 U

Positive result supports Positive result Positive result Positive result Positive result Positive result
the diagnosis of Sjögren supports diagnosis supports supports diagnosis supports supports
syndrome or other connective of Sjögren syndrome diagnosis of SLE of mixed connective diagnosis of diagnosis of
tissue disease (CTD) or other CTD tissue disease scleroderma polymyositis

NOTE: Positive results are not diagnostic for any CTD and should be interpreted within the clinical context of the patient.

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