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自身免疫性甲状腺炎患者中非器官特异性抗体作为风湿性疾病预测标志物的患病率及临床意义。

Prevalence and clinical significance of nonorgan specific antibodies in patients with autoimmune thyroiditis as predictor markers for rheumatic diseases.

作者信息

Elnady Basant M, Kamal Naglaa M, Shaker Raneyah H M, Soliman Amal F, Hasan Waleed A, Alghamdi Hamed A, Algethami Mohammed M, Jajah Mohamed Bilal

机构信息

Department of Physical Medicine and Rheumatology, Benha Faculty of Medicine, Benha University, Benha, Egypt Department of Rheumatology, Alhada Armed Forces Hospital, Taif, Saudi Arabia Department of Pediatrics and Pediatric Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt Department of Pediatrics, Alhada Armed Forces Hospital, Taif, Saudi Arabia Department of Public Health, Benha Faculty of Medicine, Benha University, Benha, Egypt Director of Armed Forces Hospitals, Taif, Saudi Arabia Departments of Pulmonology and Endocrinology, Al Hada Armed Forces Hospital, Taif, Saudi Arabia.

出版信息

Medicine (Baltimore). 2016 Sep;95(38):e4336. doi: 10.1097/MD.0000000000004336.

Abstract

Autoimmune diseases are considered the 3rd leading cause of morbidity and mortality in the industrialized countries. Autoimmune thyroid diseases (ATDs) are associated with high prevalence of nonorgan-specific autoantibodies, such as antinuclear antibodies (ANA), antidouble-stranded deoxyribonucleic acid (anti-dsDNA), antiextractable-nuclear antigens (anti-ENAs), rheumatoid factor (RF), and anticyclic-citrullinated peptides (anti-CCP) whose clinical significance is unknown.We aimed to assess the prevalence of various nonorgan-specific autoantibodies in patients with ATD, and to investigate the possible association between these autoantibodies and occurrence of rheumatic diseases and, if these autoantibodies could be considered as predictor markers for autoimmune rheumatic diseases in the future.This study had 2 phases: phase 1; in which 61 ATD patients free from rheumatic manifestations were assessed for the presence of these nonorgan-specific autoantibodies against healthy 61 control group, followed by 2nd phase longitudinal clinical follow-up in which cases are monitored systematically to establish occurrence and progression of any rheumatic disease in association to these autoantibodies with its influences and prognosis.Regarding ATD patients, ANA, anti-dsDNA, Anti-ENA, and RF were present in a percentage of (50.8%), (18%), (21.3%), and (34.4%), respectively, with statistically significance difference (P < 0.5) rather than controls. Nearly one third of the studied group (32.8%) developed the rheumatic diseases, over 2 years follow-up. It was obvious that those with positive anti-dsDNA had higher risk (2.45 times) to develop rheumatic diseases than those without. There was a statistically significant positive linear relationship between occurrence of disease in months and (age, anti-dsDNA, anti-CCP, RF, and duration of thyroiditis). Anti-dsDNA and RF are the most significant predictors (P < 0.0001).ATD is more associated with rheumatic diseases than previously thought. Anti-dsDNA, RF, and anti-CCP antibodies may be used as predictive screening markers of systemic lupus erythematosus and RA, with early referral to rheumatologists for close follow-up and early diagnoses for appropriate disease management of the disease, as early disease control will allow better quality of life.

摘要

自身免疫性疾病被认为是工业化国家中发病率和死亡率的第三大主要原因。自身免疫性甲状腺疾病(ATD)与非器官特异性自身抗体的高患病率相关,如抗核抗体(ANA)、抗双链脱氧核糖核酸(抗dsDNA)、抗可提取核抗原(抗ENA)、类风湿因子(RF)和抗环瓜氨酸肽(抗CCP),其临床意义尚不清楚。我们旨在评估ATD患者中各种非器官特异性自身抗体的患病率,并研究这些自身抗体与风湿性疾病发生之间的可能关联,以及这些自身抗体未来是否可被视为自身免疫性风湿性疾病的预测标志物。本研究有两个阶段:第一阶段,对61例无风湿表现的ATD患者进行评估,检测这些非器官特异性自身抗体,并与61例健康对照组进行比较;第二阶段进行纵向临床随访,系统监测病例,以确定与这些自身抗体相关的任何风湿性疾病的发生和进展及其影响和预后。关于ATD患者,ANA、抗dsDNA、抗ENA和RF的阳性率分别为(50.8%)、(18%)、(21.3%)和(34.4%),与对照组相比有统计学显著差异(P<0.5)。在超过2年的随访中,近三分之一的研究组(32.8%)患上了风湿性疾病。明显的是,抗dsDNA阳性者患风湿性疾病的风险比阴性者高(2.45倍)。疾病发生月份与(年龄、抗dsDNA、抗CCP、RF和甲状腺炎病程)之间存在统计学显著的正线性关系。抗dsDNA和RF是最显著的预测因子(P<0.0001)。ATD与风湿性疾病的关联比以前认为的更为密切。抗dsDNA、RF和抗CCP抗体可作为系统性红斑狼疮和类风湿关节炎的预测性筛查标志物,早期转诊至风湿病专家进行密切随访和早期诊断,以便对疾病进行适当管理,因为早期疾病控制将带来更好的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/707e/5044881/a9d7a44d8506/medi-95-e4336-g002.jpg

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