ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES AND DISEASE-ACTIVITY DURING LONG-TERM FOLLOW-UP OF 70 PATIENTS WITH SYSTEMIC VASCULITIS
ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES AND DISEASE-ACTIVITY DURING LONG-TERM FOLLOW-UP OF 70 PATIENTS WITH SYSTEMIC VASCULITIS
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DOI：
10.1093/ndt/6.10.689
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发表时间：
1991-01-01
影响因子：
6.1
通讯作者：
PUSEY, CD
中科院分区：
文献类型：
--
作者：
GASKIN, G;SAVAGE, COS;PUSEY, CD
抗中性粒细胞胞浆抗体（ANCA）已被确定为原发性全身性血管炎的诊断标志物，免疫荧光分析确定了两种结合模式：细胞质（C-ANCA）和核周（P-ANCA）。为了确定ANCA的存在与复发之间的关系，并评估其作为治疗指南的适用性，我们回顾性地研究了这些检测在疾病活动长期监测中的应用。在50个月的时间里，对70名患者进行了研究，使用临床和实验室标准诊断复发，并使用国际标准化的免疫荧光法检测ANCA。19例患者在整个研究期间检测到C-或P-ANCA；其中6例（伴有C-ANCA）复发。在长期随访中，18例患者未检测到ANCA；这些患者均未复发。33例患者C-或P-ANCA间歇性存在；其中9例复发，在复发时均检测到C-ANCA。在9个病例中的6个，复发是伴随或紧跟着C-ANCA的再次出现。我们的结论是，ANCA的持续存在和再次出现可以识别出有复发风险的患者，以及最有可能从长期免疫抑制治疗中获益的患者。
Anti-neutrophil cytoplasmic antibodies (ANCA) have been identified as a diagnostic marker in primary systemic vasculitis, and immunofluorescence assays identify two patterns of binding: cytoplasmic (C-ANCA) and perinuclear (P-ANCA). We have examined retrospectively the use of such assays in long-term monitoring of disease activity, in order to determine the relationship between presence of ANCA and relapse, and to assess their suitability as a guide to therapy. Seventy patients were studied over a period of 50 months, using clinical and laboratory criteria for the diagnosis of relapse and the internationally standardised immunofluorescence assay for detection of ANCA. In 19 patients C- or P-ANCA were detectable throughout the study period; six of these (with C-ANCA) relapsed. In 18 patients ANCA were undetectable during long-term follow-up; none of these patients relapsed. In 33 patients C- or P-ANCA were intermittently present; nine of these relapsed and all had C-ANCA detectable at the time of relapse. In six of the nine cases, relapse was accompanied or closely preceded by reappearance of C-ANCA.We conclude that continuing presence and reappearance of ANCA may identify patients who are at risk of relapse and who are most likely to benefit from long-term immunosuppressive therapy.