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General Medicine · Rheumatology: anti-topoisomerase I antibody
Sample itemA 38-year-old woman has rapidly progressive skin thickening of the fingers, forearms, upper arms and trunk over 8 months, with exertional breathlessness and fine bibasal crackles. Which autoantibody is most likely to be present?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Anti-topoisomerase I (Scl-70)
Diffuse cutaneous systemic sclerosis with truncal skin involvement and interstitial lung disease is classically associated with anti-topoisomerase I antibodies. Anti-centromere antibodies mark limited disease with pulmonary hypertension rather than early lung fibrosis.
Option by option
A. Anti-Jo-1
Anti-Jo-1 is an antisynthetase antibody linked to myositis, mechanic's hands and lung disease, not truncal skin thickening.
B. Anti-topoisomerase I (Scl-70) (correct)
Correct. Anti-Scl-70 marks diffuse skin disease with a high risk of interstitial lung fibrosis.
C. Anti-centromere
Anti-centromere antibody belongs to limited cutaneous disease with skin change distal to the elbows.
D. Anti-Sm
Anti-Sm is specific for lupus and does not cause progressive skin sclerosis.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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