19th February 2024

A 56-year-old female presents to the rheumatology clinic with dysphagia

A 56-year-old female presents to the rheumatology clinic with dysphagia. She has been experiencing nine months of progressive difficulty swallowing. She also notes a 4-year history of her fingers becoming white and painful when exposed to the cold weather. She also has associated myalgia and arthralgia in her hands and feet. She described a one-month history of increasing shortness of breath on exertion.

Examination reveals telangiectasia across her face and fingers. Her fingers also appear thickened and shiny. Several firm white nodules are noted along her fingers, some discharging chalk-like material. CXR was normal. Echocardiograms showed signs of mild pulmonary arterial hypertension.

Given the likely diagnosis, which autoantibodies are likely to be positive?

Select the SINGLE most appropriate option from the list below. Select ONE option only.