Anti-centromere autoantibody in a patient evolving from a lupus/Sjögren's overlap to the CREST variant of scleroderma

J Rheumatol. 1998 Jul;25(7):1419-24.


We characterized the development of the anti-centromere antibody in a patient prior to the development of CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias) symptoms. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis followed by immunoblotting (IgG and IgM) of cellular extracts enriched for centromere antigens and indirect immunofluorescence were used to study the anti-centromere immune response. The sera recognized 3 centromere antigens with molecular masses 18,000 (CENP-A), 50,000 (CENP-D), and 80,000 (CENP-B). For CENP-A, IgM was present before the appearance of the IgG response. Anti-CENP-D revealed an IgM response that decreased over time but no IgG, while CENP-B showed an IgG response that strengthened and then weakened over time. The appearance of an anti-centromere nuclear fluorescence pattern correlated with the appearance of IgG anti-CENP-A. Signs and symptoms typical of CREST began about 4 years after antibodies to centromere antigens were found. The development of the CREST syndrome in our patient was preceded by the appearance of anti-centromere autoantibodies. For at least one of the antigens (CENP-A), there was an immunoglobulin class switch from IgM to IgG.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Autoantibodies / immunology*
  • CREST Syndrome / complications
  • CREST Syndrome / immunology*
  • Centromere / immunology*
  • Female
  • Humans
  • Immunoblotting
  • Lupus Vulgaris / complications
  • Lupus Vulgaris / immunology*
  • Microscopy, Fluorescence
  • Sjogren's Syndrome / complications
  • Sjogren's Syndrome / immunology*


  • Autoantibodies