Shiel W C, Jason M
Arthritis Center of Southern Orange County, Mission Viejo, CA 92691.
J Rheumatol. 1989 Jun;16(6):782-5.
The referral of patients with positive antinuclear antibodies (ANA) to a rheumatologist for evaluation occurs commonly in clinical practice. We report our experience in a large community setting. Two hundred seventy-six patients (8.8% of total referrals) had ANA titers greater than or equal to 1:40 without a diagnosis. A specific diagnosis was made in 239 patients (86.6%) and no diagnosis in 37 (13.4%). Of those diagnosed, 142 (51.4%) had connective tissue diseases, 44 (15.9%) had organ-specific autoimmune diseases, 23 (8.3%) had infectious diseases, 8 (2.9%) had neoplasia and 30 (10.9%) had miscellaneous other diseases. The commonest were systemic lupus erythematosus (SLE) in 52 (18.8%) and autoimmune thyroid disease in 29 (10.5%). Undiagnosed autoimmune thyroid disease and SLE are common diagnostic associations of positive ANA in patients referred to a community rheumatologist and positive ANA are frequently associated with clinical disease.
在临床实践中，抗核抗体（ANA）阳性的患者被转诊至风湿病专科医生处进行评估的情况很常见。我们报告了在大型社区环境中的经验。276例患者（占总转诊患者的8.8%）ANA滴度大于或等于1:40但未确诊。239例患者（86.6%）得到了明确诊断，37例（13.4%）未确诊。在确诊的患者中，142例（51.4%）患有结缔组织病，44例（15.9%）患有器官特异性自身免疫性疾病，23例（8.3%）患有感染性疾病；8例（2.9%）患有肿瘤，30例（10.9%）患有其他各类疾病。最常见的是系统性红斑狼疮（SLE）52例（18.8%）和自身免疫性甲状腺疾病29例（10.5%）。未确诊的自身免疫性甲状腺疾病和SLE是转诊至社区风湿病专科医生的ANA阳性患者常见的诊断关联，且ANA阳性常与临床疾病相关。
