What monitoring would you pursue in a female patient with repeatedly very high titer centromere antibodies but no clinical symptoms of systemic sclerosis or other connective tissue disease?

For an asymptomatic patient with very high–titer anticentromere antibodies (ACA), monitoring should focus on early detection of systemic sclerosis (SSc) and related organ involvement, as higher ACA levels are associated with increased risk of progression. Risk stratification is informed by the devel...

Counsel her regarding the symptoms to be on the look-out for: digital pitting, ulcers, GERD, Raynaud, and photosensitivity. See if autoimmunity runs in her family. She may have +ACA due to +FH. Make sure she does not have thyroid disease or PBC. Beyond that, just reassure her and see her back in a y...