Frequency and clinical significance of anticentromere and anti Scl-70 antibodies in an English connective tissue disease population.

To determine the clinical significance of anti-centromere (ACA) and anti Scl-70 antibodies in an English population with connective tissue diseases, we examined the sera of 150 patients, including 40 with systemic sclerosis (SS), who were prospectively studied on the same clinical protocol in our connective tissue disease clinic. ACA was present in 44% of the CREST patients as opposed to only 12% of those with SS and diffuse skin involvement. Only two patients without SS had ACA. Anti Scl-70 was detected in 20% of the patients with SS and only two of those with other connective tissue diseases. We confirmed the specificity of these antibodies for SS. Either anti Scl-70 or ACA was present in half the patients with SS and their presence may represent a useful aid to diagnosis of this disease in patients presenting with Raynaud's phenomenon or an undifferentiated connective tissue disease. While less than half the CREST patients had ACA, this antibody appears to identify those patients within the CREST variant with skin involvement confined to sclerodactyly as opposed to those with acrosclerosis. These patients, however, did not differ in the degree of visceral involvement.