Cooley H M, Melny B J, Gleeson R, Greco T, Kay T W
Clinical Immunology and Allergy Service, Royal Melbourne Hospital, Parkville, Victoria, Australia.
J Rheumatol. 1999 Mar;26(3):563-7.
To ascertain the clinical and serological associations of anti-Ku antibody.
Twenty-seven patients over a 7 year period (1987-1996) had anti-Ku antibody detected by counterimmunoelectrophoresis (CIEP). Nineteen patients were available for clinical review. Five patients were assessed by chart review. Serum was taken at review for repeat antibody analysis. Patients were assigned to diagnostic groups based on the American College of Rheumatology criteria.
There were 22 women and 5 men. The duration of symptoms ranged from one year to 28 years. Nine patients fulfilled criteria for systemic lupus erythematosus (SLE), 4 scleroderma, 3 rheumatoid arthritis (RA), one discoid lupus, and 7 had an undifferentiated connective tissue disease. There was a low incidence of renal (2/24) and central nervous system involvement (1/24); 19/24 had Raynaud's phenomenon, 15/24 had inflammatory arthritis but only one had erosions on radiograph; 11/24 reported esophageal reflux symptoms. Three of 24 patients had myositis. All patients had anti-nuclear antibody using indirect immunofluorescence of > 640 titer with a speckled and nucleolar pattern. Anti-Ku antibody was detected on CIEP in 15/19 sera available for repeat testing. Three patients had anti-Ro antibody, 2 had anti-U1RNP antibody, one patient had anti-topoisomerase-1 and anti-Ro.
Anti-Ku antibody is found in a wide variety of connective tissue syndromes. While several patients fulfilled diagnostic criteria for SLE, scleroderma, and RA, their clinical features were usually mild and did not form a distinctive clinical pattern. Common features associated with anti-Ku were Raynaud's phenomenon, arthralgia, skin thickening, and esophageal reflux. Few patients had associated autoantibody specificities found in SLE or scleroderma.
确定抗Ku抗体的临床和血清学关联。
在7年期间（1987 - 1996年），通过对流免疫电泳（CIEP）检测了27例患者的抗Ku抗体。19例患者可进行临床复查。5例患者通过病历回顾进行评估。复查时采集血清进行抗体复测。根据美国风湿病学会标准将患者分为不同诊断组。
有22名女性和5名男性。症状持续时间从1年到28年不等。9例患者符合系统性红斑狼疮（SLE）标准，4例符合硬皮病标准，3例符合类风湿关节炎（RA）标准，1例符合盘状红斑狼疮标准，7例患有未分化结缔组织病。肾脏受累（2/24）和中枢神经系统受累（1/24）的发生率较低；19/24有雷诺现象，15/24有炎性关节炎，但只有1例在X线片上有侵蚀；11/24报告有食管反流症状。24例患者中有3例患有肌炎。所有患者使用间接免疫荧光法检测抗核抗体效价均>640，呈斑点状和核仁型。在可进行复测的19份血清中，有15份通过CIEP检测到抗Ku抗体。3例患者有抗Ro抗体，2例有抗U1RNP抗体，1例患者有抗拓扑异构酶-1和抗Ro抗体。
抗Ku抗体在多种结缔组织综合征中均有发现。虽然有几名患者符合SLE、硬皮病和RA的诊断标准，但其临床特征通常较轻，未形成独特的临床模式。与抗Ku相关的常见特征有雷诺现象、关节痛、皮肤增厚和食管反流。很少有患者具有SLE或硬皮病中发现的相关自身抗体特异性。
