Jorgensen C, Anaya J M, Cognot C, Sany J
Department of Immuno-Rheumatology, Hôpital Saint-Eloi, Montpellier, France.
Clin Exp Rheumatol. 1992 Nov-Dec;10(6):571-5.
We measured the serum immunoglobulins in 191 patients with rheumatoid arthritis (RA) over an 8-month period, looking for a relationship between high IgA levels, disease activity, and clinical and biological features. Twenty-nine patients with a polyclonal hyperimmunoglobulin A (IgA) (15.2%) above 5 g/l constituted group A. A control group of 29 randomized RA patients with normal IgA levels was studied over the same period (group B). The mean serum IgA concentration was significantly elevated in group A: 6.6 +/- 1.8 g/l versus 2.8 +/- 0.9 g/l in group B (p < 0.01). In group A, microscopic haematuria occurred in 20.7% of the cases, as against 3.4% from group B (p < 0.05). Furthermore, the incidence of unilateral sacroiliitis and of arthritis of the distal interphalangeal joints was significantly increased in group A (41.4% and 34.5%, respectively) against 6.9% and 3.4% in group B (p < 0.01) and this correlated with a high IgA serum level (p < 0.01). On the other hand, neither disease activity nor the biological parameters of inflammation were influenced by the level of IgA. Patients with RA associated with high levels of IgA are characterized by a significant increase in the incidence of distal interphalangeal arthritis, unilateral sacroiliitis and microscopic haematuria. These clinical and biological features could define a distinct subgroup of patients with RA.
我们在8个月的时间里对191例类风湿关节炎（RA）患者的血清免疫球蛋白进行了检测，以寻找高IgA水平、疾病活动度与临床及生物学特征之间的关系。29例多克隆性高免疫球蛋白A（IgA）水平高于5 g/l的患者（占15.2%）构成A组。同期对29例IgA水平正常的随机选取的RA患者组成的对照组（B组）进行了研究。A组的平均血清IgA浓度显著升高：分别为6.6±1.8 g/l和B组的2.8±0.9 g/l（p<0.01）。A组中20.7%的病例出现镜下血尿，而B组为3.4%（p<0.05）。此外，A组单侧骶髂关节炎和远端指间关节关节炎的发生率显著增加（分别为41.4%和34.5%），而B组分别为6.9%和3.4%（p<0.01），且这与高IgA血清水平相关（p<0.01）。另一方面，疾病活动度和炎症的生物学参数均不受IgA水平的影响。IgA水平高的RA患者的特征是远端指间关节炎、单侧骶髂关节炎和镜下血尿的发生率显著增加。这些临床和生物学特征可能定义了一个独特的RA患者亚组。
