Audio Qbank – Q244 – A 21F with sore hands

 

A 21-year-old woman presents to the physician for a one-month history of increasingly sore hands. Physical examination shows no abnormalities. She works in an office and uses a computer frequently. She has been managing her pain with ibuprofen. She has type I diabetes mellitus and was hospitalized three years ago for an episode of pericarditis. She does not drink or smoke. Full blood count shows no abnormalities. An x-ray of her hands is shown.

An antibody panel is ordered. Positive titers are detected against citrullinated proteins. This patient is most likely to have antibodies against which of the following targets?