Question

3 patients feel numb finger tips. Facial skin is tightened. ANA +ve. IF nucleolar pattern

• A. Systemic sclerosis
• B. Sjogren’s syndrome
• C. SLE
• D. RA

Answer 1

The Correct Option is A

To determine the correct diagnosis given the symptoms and laboratory findings, let's analyze each component:

• Symptoms: Numb finger tips and tightened facial skin suggest a connective tissue disorder.
• Laboratory Findings: A positive ANA (Antinuclear Antibody) test with a nucleolar pattern.

Given these findings, let's examine the options:

• Systemic sclerosis: This condition is characterized by skin tightening due to collagen deposition and is often associated with a positive ANA test displaying a nucleolar pattern. It can also result in numbness in extremities due to scleroderma affecting the fingertips (sclerodactyly and digital ulcers).
• Sjogren’s syndrome: Typically presents with dry eyes and mouth (sicca symptoms) and generally has anti-Ro/SSA or anti-La/SSB antibodies.
• SLE (Systemic Lupus Erythematosus): Although associated with a positive ANA, the typical antibody pattern is homogeneous, speckled, or peripheral rather than nucleolar.
• RA (Rheumatoid Arthritis): Primarily affects joints and is not commonly associated with a nucleolar ANA pattern.

Based on the symptoms of finger numbness, tightened facial skin, and the ANA nucleolar pattern, the diagnosis that best fits is Systemic sclerosis.