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Signature ✍️
- "Autoantibody craze" refers to the finding of variable autoantibody positivity that may or may not be accompanied consequential autoimmune disease(s)
- Non-specific accompanying laboratory clues include polyclonal hypergammaglobulinemia (i.e. surrogate for divergent autoantibody production), as well as the finding of a ⊕ rheumatoid factor*
- Non-specific accompanying clinical clues include B-symptoms & lymphadenopathy, which both suggest a hyperactive immune system
⚪ Rheumatoid factor positivity indicates the presence of IgM antibodies against the Fc portion of IgG, which can be driven by numerous chronic inflammatory processes
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DDx 🏳️🌈
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Malignancy
- LGL Leukemias
- Angioimmunoblastic T-cell lymphoma (AITL)
- MDS/CMML
- Castleman disease
- Thymoma
- RAS-associated autoimmune leukoproliferative disorder
Clonal Hematopoiesis
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- Prescriptions
- Drug-induced SLE & AAV
- Immune checkpoint inhibitors
- Recreational
- Adjuvants
- Silicone breast implant leak (ASIA Syndrome)
- Post-vaccination
- Inhaled
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- Infective endocarditis (⊕ ANCAs, ↓ C3/C4, APS antibodies)
- Tuberculosis (anti-Scl-70, anti-cardiolipin)
- Syphilis (anti-cardiolipin, ANA, F-actin)
- Q Fever (”immunological arousal”)
- Bartonellosis (⊕ ANCAs with Hypocomplementemia)
- Schistosomiasis (pan-positive ANAs)
- Leishmaniasis (ANA, dsDNA, ANCA)
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