A 36-year-old woman comes to the physician because of dysphagia. Physical examination shows clawlike hands secondary to “tightened” skin; small, flat red skin marks around the upper extremities; and three small (<2.5 cm) subcutaneous nodules in her right forearm. Her hands are very sensitive to cold weather, and she wears winter gloves in air-conditioned stores to prevent her hands from cramping up and getting pale. Which of the following would most likely be abnormally elevated on further evaluation?
(A) Anticentromere antibody
(B) anti-Smith antibodies
© IgM anti-IgG
(D) Lower esophageal sphincter tone