Sauvaget F, Johanet C, De Gennes C, Raguin G, Abuaf N, Blétry O, Guillevin L, Homberg J C, Godeau P
Service de Médecine Interne, Hôpital de la Pitié-Salpêtrière, Paris.
Ann Dermatol Venereol. 1990;117(2):103-7.
We looked for anti-Scl-70 and anti-centromere antibodies in 109 patients (26 men and 83 women). Mean age was 43 +/- 15 years. Forty patients had systemic sclerosis according to ARA criteria. The extension of cutaneous involvement was defined by using Barnett and Coventry criteria: 12 patients were type I (sclerodactyly), 20 type II (acrosclerosis) and 8 type III (diffuse scleroderma). Among the 12 patients with type I, there were 8 cases of CREST syndrome defined as follows: presence of sclerodactyly, Raynaud's phenomenon and 2 of the 3 following criteria: oesophageal dysmotility, calcinosis, telangiectasia. Other organ involvement was recorded. Control patients had idiopathic Raynaud's phenomenon (n = 22), other connective tissue diseases (n = 20), and miscellaneous diseases (n = 28). Ninety-nine patients were prospectively included in this study. Patients' sera were stored at -20 degrees C. Ten previously stored sera obtained from patients with systemic sclerosis were also analyzed. Immunological tests were performed simultaneously and with no information on the diagnosis. When antinuclear antibodies were detected by indirect immunofluorescence, double immunodiffusion and immunoblotting were performed. Anti-Scl-70 antibodies were detected in systemic sclerosis only: 1 of 12 type I, 11 of 20 type II and 4 of 8 type III. One serum negative by immunodiffusion was positive using immunoblotting. We found that the specificity of anti-Scl-70 antibodies for systemic sclerosis was 100 p. 100 and their sensitivity 40 p. 100. There was a correlation between the presence of anti-Scl-70 antibodies and the presence of antinuclear antibodies (p less than 0.05) and the extent of cutaneous involvement (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
我们对109例患者(26例男性和83例女性)进行了抗Scl - 70和抗着丝点抗体检测。平均年龄为43±15岁。根据美国风湿病学会(ARA)标准,40例患者患有系统性硬化症。采用Barnett和Coventry标准定义皮肤受累范围:12例为I型(硬皮病指),20例为II型(肢端硬化症),8例为III型(弥漫性硬皮病)。在12例I型患者中,有8例符合CREST综合征,定义如下:存在硬皮病指、雷诺现象以及以下3项标准中的2项:食管运动障碍、钙质沉着、毛细血管扩张。记录了其他器官受累情况。对照患者包括特发性雷诺现象(n = 22)、其他结缔组织病(n = 20)和其他杂病(n = 28)。99例患者被前瞻性纳入本研究。患者血清储存于-20℃。还分析了之前从系统性硬化症患者处获得的10份储存血清。免疫检测同时进行,且不了解诊断信息。当通过间接免疫荧光检测到抗核抗体时,进行双向免疫扩散和免疫印迹检测。仅在系统性硬化症患者中检测到抗Scl - 70抗体:I型12例中的1例,II型20例中的11例,III型8例中的4例。1份免疫扩散阴性的血清经免疫印迹检测呈阳性。我们发现抗Scl - 70抗体对系统性硬化症的特异性为100%,敏感性为40%。抗Scl - 70抗体的存在与抗核抗体的存在(p < 0.05)以及皮肤受累程度(p < 0.05)之间存在相关性。(摘要截短于250字)