Detection of antisynthetase syndrome in patients with idiopathic interstitial pneumonias
Detection of antisynthetase syndrome in patients with idiopathic interstitial pneumonias
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DOI：
10.1016/j.rmed.2011.03.022
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发表时间：
2011-08-01
影响因子：
4.3
通讯作者：
Mishima, Michiaki
中科院分区：
文献类型：
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作者：
Watanabe, Kizuku;Handa, Tomohiro;Mishima, Michiaki
目的：抗合成酶综合征（ASS）的特征是对氨酰-tRNA合成酶（抗合成酶）的自身抗体，并且它经常与间质性肺病相关。本研究的目的是阐明特发性间质性肺炎（IIPs）中抗合成酶阳性亚群的患病率和特点，并阐明筛查这些抗体的重要性。在所有病例中进行6种抗合成酶抗体的筛查。所有病例的临床特征与抗合成酶的存在进行了比较。结果：抗合成酶阳性13例（6.6%）。抗EJ最普遍，其次是抗PL-12。抗合成酶阳性者发病年龄较阴性者年轻。抗合成酶阳性6例（46.2%），无肺外特征。组织学上，在5例有淋巴滤泡的UIP和11例NSIP中，抗合成酶抗体阳性率为8/16（50%）。HRCT上抗合成酶抗体阳性者主要表现为毛玻璃样阴影和牵拉性支气管扩张，无蜂窝样改变。在IIP中，尤其是在病理性NSIP或具有淋巴滤泡的UIP中，应筛查抗合成酶。这些患者应进行抗合成酶筛查，即使不存在提示性肺外表现。(C)2011爱思唯尔有限公司保留所有权利。
Objectives: Antisynthetase syndrome (ASS) is characterized by autoantibodies to aminoacyl-tRNA synthetases (anti-synthetase) and it is frequently associated with interstitial lung disease. The purpose of this study was to elucidate the prevalence and characteristics of the anti-synthetase positive subpopulation among idiopathic interstitial pneumonias (IIPs) and to clarify the importance of screening for these antibodies.Methods: A retrospective study was performed in 198 consecutive cases with IIPs. Screening for six anti-synthetase antibodies was performed in all cases. Clinical profiles of all cases were compared with reference to the presence of anti-synthetase. High-resolution computed tomography (HRCT) findings of anti-synthetase positive cases were also analyzed.Results: 13 cases (6.6%) were positive for anti-synthetase. Anti-EJ was most prevalent, followed by anti-PL-12. Onset ages of anti-synthetase positive cases were younger than those of anti-synthetase negative cases. Extrapulmonary features of ASS were absent in 6 anti-synthetase positive cases (46.2%). Histologically, among 5 UIP with lymphoid follicles and 11 NSIP cases, the prevalence of anti-synthetase positive cases was 8/16 (50%). On HRCT, ground glass opacity and traction bronchiectasis were the major findings in anti-synthetase positive cases, while honeycombing was absent.Conclusions: Anti-synthetase positive cases were not rare among IIPs. Anti-synthetase should be screened for in IIPs, especially in pathological NSIP or UIP with lymphoid follicles. These patients should be screened for anti-synthetase even if no suggestive extrapulmonary manifestation exists. (C) 2011 Elsevier Ltd. All rights reserved.