Suzuki Shigeaki
Department of Neurology, Keio University School of Medicine.
Rinsho Shinkeigaku. 2011 Nov;51(11):961-3. doi: 10.5692/clinicalneurol.51.961.
Detection of autoantibodies can provide more important clinical information in assigning patients to clinical subsets, selecting a therapy and predicting prognosis. Muscle biopsy is the principal examination for a diagnosis of myositis; however, autoantibody detection is also useful. Myositis-associated autoantibodies, detected in 30% of myositis patients, can be screened by RNA immunoprecipitation assay. Some case series have revealed that the anti-SRP antibody, detected in 5-8% of polymyositis patients, was generally associated with severe and refractory polymyositis. However, it has been accepted that anti-SRP myopathy should be separated from polymyositis based on histological and clinical features. Some patients with anti-SRP myopathy show chronic progression indistinguishable from muscular dystrophy.
自身抗体的检测在将患者分配到临床亚组、选择治疗方法和预测预后方面可提供更重要的临床信息。肌肉活检是诊断肌炎的主要检查方法;然而,自身抗体检测也很有用。在30%的肌炎患者中检测到的肌炎相关自身抗体可通过RNA免疫沉淀试验进行筛查。一些病例系列研究表明,在5%-8%的多发性肌炎患者中检测到的抗SRP抗体通常与严重难治性多发性肌炎相关。然而,基于组织学和临床特征,抗SRP肌病应与多发性肌炎区分开来已被广泛接受。一些抗SRP肌病患者表现出与肌肉营养不良难以区分的慢性进展。