风湿

单纯抗SSB抗体阳性与系统性自身免疫病

作者:Jardel S 来源:中国风湿病公众论坛 日期:2017-10-12
导读

         单纯抗SSB抗体阳性与系统性自身免疫病的临床表现不相关

        摘要:

        目的:评价在临床实践中,抗SSB抗体阳性/SSA抗体阴性的发生率和诊断价值。

        方法:我们分析了连续一年时间内由临床医生送至免疫学实验室检测抗SSA和/或抗SS-B抗体的病例,共624例,应用Luminex技术进行抗体检测。对单纯抗SSB抗体阳性的患者进行数据分析。临床特点和结缔组织疾病的诊断根据国际标准进行检索。

        结果:624例患者的1173份抗SSA抗体和/或SSB抗体阳性的血清阳性标本中,共确定84例(13.5%)单纯抗SSB抗体阳性。在具有临床数据的75例阳性患者中,15例诊断为结缔组织病(20%),包括4例系统性红斑狼疮(5%),4例类风湿关节炎(5%),2例特发性炎性肌病(3%),1例原发性干燥综合征 (1%),1例系统性硬化症(1%),2例未分化结缔组织病 (3%),和1例混合性结缔组织病(1%)。在60例其他患者中,18例患有非结缔组织病自身免疫病,42例患非自身免疫性疾病。在结缔组织病患者中,单纯抗SS-B抗体阳性与提示某一特殊综合征的临床特征不相关。结缔组织病的诊断与抗SSB抗体水平无相关性 (p = 0.70)。关节痛是最常见的症状,共有10例具有关节痛表现(67%),其中3例具有关节炎。

        结论:应用Luminex技术检测抗SSB抗体阳性而抗SSA抗体阴性与结缔组织病尤其原发性干燥综合征不相关。我们的数据提示SSB抗体阳性对于原发性干燥综合症的分类标准并无贡献价值。

        附原文:Abstract:OBJECTIVE:To assess in clinical practice the frequency and diagnosisassociated with the SS-B-positive/SS-A negative autoantibody profile.METHODS:Weanalyzed a one-year consecutive population of 624 patients referred byclinicians to the immunology laboratory to investigate anti-SS-A and/oranti-SS-B autoantibodies, who were detected using luminex technology. Data wereanalyzed for patients with isolated anti-SS-B autoantibodies. The clinicalcharacteristics and diagnosis of connective tissue diseases (CTD) wereretrieved according to the international criteria.RESULTS:Among 1173 serapositive for anti-SS-A and/or anti-SS-B autoantibodies from 624 patients, weidentified 84 patients (13.5%) that had isolated anti-SS-B. Among the 75patients positive for anti-SS-B with known clinical data, 15 were diagnosedwith a CTD (20%) including 4 systemic lupus erythematosus (5%),4rheumatoid arthritis(5%), 2 idiopathic inflammatory myositis (3%),1 primary Sjögren's syndrome pSS (1%), 1 systemic sclerosis (1%), 2 undefinedCTD (3%), and 1 mixed CTD (1%). Among the 60 other patients, 18 had non-CTDautoimmune diseases and 42 had non-autoimmune diseases. Within the CTDpopulation, the presence of isolated anti-SS-B was not significantly associatedto characteristic indicating a specific syndrome. There was no associationbetween diagnosis of CTD and level of anti-SS-B autoantibodies (p = 0.70).Arthralgia was the more frequent sign and encountered in 10 patients (67%), ofwhom 3 hadarthritis.CONCLUSION:The presence of anti-SS-B, withoutanti-SS-A autoantibodies using luminex technology, was not associated with CTD,especially pSS, in daily clinical practice. Our data suggests that the SS-Bserological profile is not contributive for the classification criteria of pSS.

        引自:Jardel S,Fabien N,Hot A,et al.Isolated positive anti-SS-B autoantibodies are notrelated to clinical features of systemic autoimmune diseases: Results from aroutine population survey.PLoS One.2017;12(9):e0185104. doi: 10.1371/journal.pone.0185104.

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