Persistent antinuclear antibodies in children without identifiable inflammatory rheumatic or autoimmune disease.
Persistent antinuclear antibodies in children without identifiable inflammatory rheumatic or autoimmune disease.
复制标题
儿童中持续存在抗核抗体，没有可识别的炎症性风湿病或自身免疫性疾病。
作者：
D. Cabral;R. Petty;M. Fung;P. Malleson
108名儿童肌肉骨骼疼痛被认为不是由于自身免疫性或炎症性疾病进行了抗核抗体（ANA）测试。在1：20的筛选血清稀释度下，这些儿童中有24名在HEp-2细胞底物上ANA呈阳性。24例患者中有21例ANA试验阳性，平均持续时间为38个月（范围1至103个月）。通过放射免疫测定或间接免疫荧光法对Crithidia luciliae进行初步评价时，任何患者的血清均未检测到抗DNA抗体。1例患者最近出现抗DNA（放射免疫测定）抗体升高，但对C luciliae的检测结果仍为阴性。4例患者通过免疫印迹法检测到核心组蛋白抗体。没有抗体的Sm，RNP，Ro（SS-A），或La（SS-B）的对流免疫电泳。在平均61个月（范围13至138个月）的随访期内，没有患者发生明显的炎症或自身免疫性疾病。肌肉骨骼疼痛和ANA检测阳性的儿童，但没有炎症或自身免疫性疾病的临床证据，迫切发展这种疾病的风险较低。
One hundred eight children with musculoskeletal pain considered not to be due to an autoimmune or inflammatory disease had an antinuclear antibody (ANA) test performed. Twenty-four of these children were ANA positive on HEp-2 cell substrate at a screening serum dilution of 1:20. A positive ANA test persisted in 21 of 24 of the patients over a mean time period of 38 months (range 1 to 103 months). No sera from any patient at initial evaluation had anti-DNA antibodies by radioimmunoassay or by indirect immunofluorescence on Crithidia luciliae. One patient recently developed elevated anti-DNA (radioimmunoassay) antibodies but still has a negative assay on C luciliae. Four patients had antibodies to core histones by immunoblotting. None had antibodies to Sm, RNP, Ro (SS-A), or La (SS-B) by counterimmunoelectrophoresis. No patient developed an overt inflammatory or autoimmune disease during a mean follow-up period of 61 months (range 13 to 138 months). A child with musculoskeletal pain and a positive test for ANA, but with no clinical evidence at presentation of inflammatory or autoimmune disease, is at low risk of imminently developing such a disease.