What is Anti-SS-A Antibody test? 

An anti-SSA (anti-Sjögren’s syndrome related antigen A) antibody test is a blood test chiefly used in the diagnosis of Sjögren’s syndrome - an autoimmune disorder characterised by dry mouth and dryness in eyes

Normally our body produces a set of proteins - antibodies - to fight harmful biological compounds (antigens). However, in autoimmune disorders, the immune system mistakenly starts to produce antibodies against its own cells. These antibodies are called autoantibodies. They harm and destroy the body tissues, causing autoimmune disorders. 

The RO/SSA antibodies are a type of autoantibodies produced against specific RNA proteins present inside the nucleus of healthy cells. It is present in about 70% people with Sjögren’s syndrome. 

SSA antibodies are also found in those with other autoimmune disorders such as systemic lupus erythematosus (SLE), subcutaneous lupus erythematosus (SCLE), rheumatoid arthritis, and Sjögren’s syndrome. 

Anti-SS-A Antibody test looks for the presence of SSA antibodies in the bloodstream of a person to confirm the presence of any of the above-mentioned autoimmune conditions.  

A rheumatoid arthritis (RA) factor test is commonly performed along with the anti-SS antibody test to help in the diagnosis of Sjögren’s syndrome.

  1. Why is an Anti-SS-A Antibody test performed?
  2. How do you prepare for an Anti-SS-A Antibody test?
  3. How is an Anti-SS-A Antibody test performed?
  4. Anti-SS-A Antibody test results and normal range

Doctors order an anti-SSA antibody test when a person shows positive results in an anti-nuclear antibody (ANA) test and have clinical symptoms suggestive of an autoimmune disorder. This is because, the ANA test only detects autoimmune disorders, such as SLE, Sjögren’s syndrome, neonatal lupus and rheumatoid arthritis, but it does not diagnose any specific form of autoimmune disease. 

The anti-SS antibody test, on the other hand, is chiefly done to confirm the diagnosis of Sjögren’s syndrome and differentiate it from SLE. The latter is then diagnosed with the help of anti-SSB antibody test. The symptoms of Sjögren’s syndrome include:

  • Pain and swelling in joints
  • Pain and stiffness in muscles
  • Extreme tiredness, lack of concentration and poor memory
  • Rashes on the skin, especially after exposure to sunlight
  • Dryness in different parts of the body, such as mouth, throat, eyes, lips, skin, hair, nose and vagina
    • Dryness of the mouth due to decreased secretion of saliva causes difficulty in chewing and swallowing food. The tongue becomes dry and sore and tends to stick to the roof of the mouth. Some people may have altered taste, formation of ulcers and inflammation or redness and soreness inside the mouth. Disorders related to teeth and gums, such as tooth decay, also commonly occur due to dryness of the mouth.
    • Dryness in the throat causes hoarseness of voice and burning sensation in the throat. 
    • Dry eyes due to insufficient production of tears cause pain, redness, burning and sand-like sensation or sensation of foreign body in the eyes. Dry eyes also lead to unclear vision, discomfort in bright light and stickiness of eyelids.
    • Dryness of the skin and lips leads to cracks at the corners of the mouth. Itching due to dryness of skin is also common.
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You do not require any special preparation for an anti-SSA antibody test.

A nurse or laboratory technician will collect a blood sample from your arm and store it in a red-top tube. He.she will label the sample and send it to the laboratory for analysis. Bleeding or infection at the site of needle insertion may occur in some cases. If you notice redness, pain or swelling at the site, inform your doctor immediately.

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Normal results: 

  • < 1.0 U indicates negative for anti SS-A antibodies

Abnormal results: 

  • ≥ 1.0 U indicates positive for anti SS-A antibodies.

Abnormal results indicate the presence of conditions such as: 

  • Neonatal lupus: It is an autoimmune disorder which occurs due to the transfer of autoantibodies through the placenta from the mother (suffering from autoimmune disorder) to the baby during pregnancy. The main symptoms include redness and burning of skin on exposure to sunlight, abnormality in heartbeats (congenital atrioventricular block), liver disorder and abnormality in the red blood cells which causes anaemia.

  • Scleroderma: Scleroderma is an autoimmune disorder associated with excessive calcium deposition in the connective tissue. It is characterised by tightening and hardening of skin and narrowing of blood vessels in the limbs, which leads to pain and swelling in the hands, feet and fingers (Raynaud’s phenomenon). People suffering from scleroderma also get swelling in the oesophagus (food pipe) that causes difficulty in swallowing.

  • ANA-negative lupus: It is a type of lupus in which the patient does not show antinuclear antibodies. Symptoms of ANA-negative SLE are a bit less severe than SLE but the person experiences more prominent photosensitivity of skin.

  • Sjögren’s syndrome.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. Christine Castro et al. Diagnostic Testing and Interpretation of Tests for Autoimmunity. J Allergy Clin Immunol. 2010 Feb; 125(2 Suppl 2): S238–S247. PMID: 20061009
  2. Denise D. Wilson. McGraw-Hill’s Manual of Laboratory & Diagnostic Tests. Rheumatoid Factor (RF, Rheumatoid Arthritis Factor). 2008. Pp. 506
  3. Fred F. Ferri, MD, FACP. Ferri’s Best Test. A Practical Guide to Clinical Laboratory Medicine and Diagnostic Imaging. Antinuclear Antibody (ANA)-Positive. 4th edition. 2019. Pp.254
  4. Li Rao et al. Specificity of anti-SSB as a diagnostic marker for the classification of systemic lupus erythematosus. Exp Ther Med. 2013 Jun; 5(6): 1710–1714. PMID: 23837059
  5. National Health Service [internet]. UK; Sjögren's syndrome
  6. Sathish Kumar. Neonatal lupus: An update. Indian Journal of Rheumatology. 2016; 11(6):139-144.
  7. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Scleroderma
  8. L.S. Cross et al. Antinuclear antibody-negative lupus as a distinct diagnostic entity—does it no longer exist?. QJM: An International Journal of Medicine, Volume 97, Issue 5, May 2004, Pages 303–308, https://doi.org/10.1093/qjmed/hch048
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