Positive anti-dsDNA antibodies are most consistent with which disease?

• A. Rheumatoid arthritis
• B. Sjögren syndrome
• C. Scleroderma
• D. Systemic lupus erythematosus (SLE)

Answer: (D)

Anti-dsDNA antibodies are a hallmark finding most strongly associated with systemic lupus erythematosus. They arise against double-stranded DNA and, among autoimmune diseases, have a high degree of specificity for SLE. Their presence not only supports the diagnosis but often tracks disease activity, particularly lupus nephritis, making them a useful marker for this condition. Other diseases listed—rheumatoid arthritis, Sjögren syndrome, and scleroderma—are typically linked to different antibodies (such as anti-CCP or rheumatoid factor in RA; anti-Ro/SSA and anti-La/SSB in Sjögren; anti-centromere or anti-Scl-70 in scleroderma). While some autoimmune diseases can have ANA positivity, anti-dsDNA is much more characteristic of SLE, which is why a positive result most strongly points to that diagnosis.