Autoantikörperdiagnostik rheumatologischer systemerkrankungen mit pulmonaler manifestation

The lung is frequently involved in disorders such as connective tissue diseases and small vessel vasculitides. Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides are often associated with alveolar haemorrhage and pulmonary granulomatous disease, whereas connective tissue disorders present with interstitial lung disease and pulmonary hypertension. Detection of ANCA directed against proteinase 3 or myeloperoxidase is helpful in the diagnosis of ANCA-associated vasculitis, and antinuclear antibodies (ANA) should be determined in cases of suspected connective tissue disease. Autoantibodies determined by ANA differentiation are often very specific for a certain type of connective tissue disease, e.g. antitopoisomerase-1 antibodies for systemic sclerosis. Autoantibody titres may correlate with disease activity or be associated with a special pattern of organ involvement and should be included in the diagnostics of connective tissue diseases and vasculitides.