These are all chronic diseases, and, if there is a life-threatening complication, the complication could be serious.
For scleroderma: if there is a fine or grainy nuclear pattern, test anti-Scl-70 (topoisomerase I); if there is a centromeric pattern, no additional tests are recommended.
In addition to the follow-up with serologic testing, patients with Sjögren syndrome can be tested for dry eyes and dry mouth by a variety of assays.
Patients with possible inflammatory muscle disease may benefit from creatine kinase testing and/or a muscle biopsy. Evaluation for RA: rheumatoid factor test (found in approximately 80% of patients with RA); x-rays, particularly of hand and wrist for joint disease; C-reactive protein test as an indicator of inflammation with or without SED rate to assess level of inflammation.