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抗丙氨酰-tRNA 合成酶(抗-PL12)抗体阳性的抗合成酶综合征的临床表现:17 例回顾性研究。

Clinical manifestations of anti-synthetase syndrome positive for anti-alanyl-tRNA synthetase (anti-PL12) antibodies: a retrospective study of 17 cases.

机构信息

Internal Medicine Department, CHU Nantes Hotel Dieu, Place Alexis Ricordeau, Nantes Cedex, France.

出版信息

Rheumatology (Oxford). 2010 May;49(5):972-6. doi: 10.1093/rheumatology/kep455. Epub 2010 Feb 15.

Abstract

OBJECTIVE

To describe the clinical manifestations of the anti-synthetase syndrome (ASS) specifically associated with anti-alanyl-tRNA (anti-PL12) synthetase antibodies.

METHODS

In a retrospective study, 17 patients (eight males, nine females, mean age = 60.3 years) with ASS symptoms confirmed by two consecutive tests (cyto-dot and/or immunoblot, or both), with positive results for anti-PL12 antibodies, were included.

RESULTS

All patients presented with interstitial lung disease (ILD), which was associated with mild myositis in 41% of the cases. RP and general impairment were common, whereas rheumatic and dermatological symptoms were uncommon. Four patients suffered from SS, and four others had an atypical oesophageal involvement. The long-term course was assessable for 10 patients (follow-up of 41.1 months). Five patients required immunosuppressive drugs. Two patients are waiting for a lung transplant because of disproportionate and refractory pulmonary hypertension.

CONCLUSION

The severity of anti-PL12 ASS varied because of the constant pulmonary involvement. ILD was the predominant prognosis factor, which was notable in cases associated with pulmonary hypertension.

摘要

目的

描述与抗丙氨酰-tRNA(抗-PL12)合成酶抗体相关的抗合成酶综合征(ASS)的临床表现。

方法

在一项回顾性研究中,纳入了 17 名 ASS 症状患者(8 名男性,9 名女性,平均年龄=60.3 岁),这些患者通过两次连续检测(细胞斑点和/或免疫印迹,或两者均阳性)确诊,且抗-PL12 抗体呈阳性。

结果

所有患者均出现间质性肺病(ILD),其中 41%的患者合并轻度肌炎。RP 和全身损害很常见,而风湿和皮肤症状不常见。4 名患者患有干燥综合征(SS),4 名患者有非典型食管受累。10 名患者的长期病程可评估(随访时间为 41.1 个月)。5 名患者需要免疫抑制药物治疗。由于不成比例且难治性肺动脉高压,有 2 名患者正在等待肺移植。

结论

抗-PL12 ASS 的严重程度因持续的肺部受累而有所不同。ILD 是主要的预后因素,在伴有肺动脉高压的病例中更为显著。

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