Clinical utility of anti-signal recognition particle antibody in the differential diagnosis of myopathies
Clinical utility of anti-signal recognition particle antibody in the differential diagnosis of myopathies
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DOI：
10.1093/rheumatology/ken325
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发表时间：
2008-10-01
期刊：
影响因子：
5.5
通讯作者：
Kuwana, M.
中科院分区：
文献类型：
--
作者：
Suzuki, S.;Satoh, T.;Kuwana, M.
目标。已知信号识别颗粒（SRP）自身抗体对风湿病中的PM具有特异性，但对肌病的特异性尚不清楚。抗srp抗体在肌病鉴别诊断中的临床应用尚未见研究。本研究旨在探讨抗srp抗体检测是否能鉴别肌营养不良症（MD）。我们报告一位儿童发病的肌病患者，尽管反复进行肌肉活检，但在临床上很难对PM或MD进行鉴别诊断21年。使用RNA免疫沉淀法，在这一特殊病例以及105份不同类型MD和84份PM患者的血清样本中筛选了针对RNA相关抗原的肌炎特异性自身抗体。MD和PM的血清样本来自不同的机构。通过RNA免疫沉淀结合SRP的免疫清除，证实了抗SRP抗体的存在。本例患者抗srp抗体阳性，支持PM诊断。7例（8.3）PM患者检测到抗srp抗体，MD患者未检测到抗srp抗体，MD患者未检测到肌炎特异性自身抗体。抗srp抗体可用于肌病患者PM和MD的鉴别。
Objective. Auto-antibodies to signal recognition particle (SRP) are known to be specific to PM among rheumatic disorders, but the specificity in myopathic diseases remains unclear. The clinical utility of anti-SRP antibody in the differential diagnosis of myopathies has not been studied. The aim of the present study was to elucidate whether detection of anti-SRP antibody can discriminate of PM from muscular dystrophy (MD).Methods. We report a patient with a childhood onset myopathy, in whom it was clinically difficult to make a differential diagnosis of PM or MD for 21 yrs, despite repeated muscle biopsies. Myositis-specific auto-antibodies to RNA-associated antigens were screened in this particular case as well as in 105 serum samples from various types of MD and 84 from PM patients using RNA immunoprecipitation. The MD and PM serum samples were obtained from different institutions. The presence of anti-SRP antibody was confirmed by RNA immunoprecipitation combined with immunodepletion of SRP from the antigen.Results. Anti-SRP antibody was positive in the present patient, supporting the diagnosis of PM. Anti-SRP antibody was detected in seven (8.3) patients with PM, but in none of the patients with MD. Myositis-specific auto-antibodies were not detected in any of the patients with MD.Conclusion. Anti-SRP antibody is useful for discriminating PM from MD among patients with myopathies.