How do you approach incidental NXP-2 antibody positivity in patients without current clinical evidence of myositis or systemic autoimmune disease?

A positive anti-NXP2 antibody in an asymptomatic patient may indicate either a false positive or a subclinical form of dermatomyositis. The initial step is to review the testing method (e.g., ELISA, immunoblot). If possible, confirm the result with a different assay, ideally immunoprecipitation, though it's often limited by cost and availability.

If the result is confirmed or retesting isn't feasible, assess for subtle signs of DM. In the absence of symptoms, patient education is key BY highligh...

Likely false +, but the question is, why was it tested? If + by 2 different labs or high titer, then watch the patient clinically for future development of autoimmunity. Otherwise, it is likely false +.