Tomioka Hiromi, Kaneko Masahiro, Kogata Yoshinori, Katsuyama Eiji, Ishikawa Seiko, Fujii Takao
Department of Respiratory Medicine, Kobe City Medical Center West Hospital, 4, 2-chome, Ichibancho, Nagata-ku, Kobe 653-0013, Japan.
Respir Investig. 2012 Jun;50(2):66-9. doi: 10.1016/j.resinv.2012.04.003. Epub 2012 May 17.
Autoantibodies against aminoacyl-tRNA synthetases (ARSs) are highly specific for myositis and/or interstitial lung disease. We report a rare case of double positive antibodies (anti-EJ antibody, the least common among anti-aminoacyl-tRNA synthetase antibodies, and anti-cyclic citrullinated peptide antibody, reported to be specific for rheumatoid arthritis) in a patient who presented with interstitial lung disease and later developed rheumatoid arthritis. The patient did not have clinically apparent myositis over a period of careful follow-up of several years. The initial pulmonary pathologic findings showed a nonspecific interstitial pneumonia pattern, with the formation of lymphoid follicles, which should be recognized as the first manifestation of rheumatoid arthritis.
抗氨酰-tRNA合成酶（ARSs）自身抗体对肌炎和/或间质性肺病具有高度特异性。我们报告了一例罕见病例，一名患有间质性肺病且后来发展为类风湿性关节炎的患者出现了双阳性抗体（抗EJ抗体，在抗氨酰-tRNA合成酶抗体中最不常见，以及抗环瓜氨酸肽抗体，据报道对类风湿性关节炎具有特异性）。在数年的仔细随访期间，该患者没有临床上明显的肌炎。最初的肺部病理表现显示为非特异性间质性肺炎模式，并伴有淋巴滤泡形成，这应被视为类风湿性关节炎的首发表现。
