Q. A 52-year-old woman comes to the physician’s office with heartburn and difficulty in swallowing for the past 2 months. It is for both solids and liquids. Recently, she noticed difficulty in breathing when climbing stairs. For the past 1 year, she also has a history of recurrent pain in her fingers and toes when exposed to cold. Soon after exposure to cold, her fingers become pale, followed by blue color. After about 20 minutes, the skin color becomes reddish. Her temperature is 98.6°F (37°C), pulse is 84 beats per minute, BP is 136/90 mm of Hg and respiratory rate is 16/min. On physical examination, her hands show nonpitting edema with puffy fingers. Multiple telangiectasias are noted on her nose, hands, and feet. The rest of the examination is normal. Laboratory Examination is shown below. Which of the following antibodies will most likely be elevated in this patient?