Which antibody is commonly associated with limited cutaneous systemic sclerosis (CREST)?

• A. Anti-centromere antibodies
• B. Anti-RNP antibodies
• C. Anti-SCL-70 antibodies
• D. Anti-dsDNA antibodies

Answer: (A)

Antibody patterns help identify the disease subset in systemic sclerosis. Limited cutaneous systemic sclerosis (CREST) is most classically linked to anti-centromere antibodies. These antibodies target centromere proteins and are associated with the CREST phenotype—calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasias. They tend to indicate milder skin involvement and slower progression, with less early, extensive organ fibrosis compared with the diffuse form. In contrast, anti-SCL-70 (anti-topoisomerase I) is more associated with diffuse cutaneous disease and higher risk of interstitial lung disease; anti-RNP is seen in mixed connective tissue disease; anti-dsDNA is characteristic of systemic lupus erythematosus. Therefore, anti-centromere antibodies are the antibody most commonly associated with CREST.