Zamarrón-de Lucas Ester, Gómez Carrera Luis, Bonilla Gema, Petit Dessiree, Mangas Alberto, Álvarez-Sala Rodolfo
Servicio de Neumología, Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Universidad Autónoma de Madrid, Madrid, España.
Servicio de Neumología, Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Universidad Autónoma de Madrid, Madrid, España.
Med Clin (Barc). 2017 Feb 23;148(4):166-169. doi: 10.1016/j.medcli.2016.11.021. Epub 2017 Jan 7.
Antisynthetase syndrome (ASS) is characterised by a series of clinical manifestations such as myositis, fever, mechanic's hands and diffuse interstitial lung disease (ILD), all associated with positivity to antisynthetase antibodies. The presence of ILD will be that, to a great extent it will mark the response to treatment and prognosis.
Eleven cases of patients with ASS and pulmonary involvement in monitoring at a Pulmonary monographic consult in a third level hospital consult are described.
Nine patients presented positivity to anti-Jo antibody and 2 to anti-PL12. Four patients' HRCT pattern showed NSIP, four UIP, one COP and 2 ground-glass opacity. A percentage of 73 were accompanied by bronchiectasis and bronchiolectasis and 27% honeycombing. Functional exploration was mainly affected by DLCO with up to 45% of the positive walking test. Corticodependence is highlighted, often requiring immunosuppressive treatment both chronically and in exacerbations. All patients maintain good prognosis so far.
Patients with interstitial lung disease should have at least a determination of antisynthetase antibodies in order to identify this disease, better prognosis than other interstitial diseases such as idiopathic pulmonary fibrosis.
抗合成酶综合征(ASS)的特征是一系列临床表现,如肌炎、发热、技工手和弥漫性间质性肺病(ILD),所有这些都与抗合成酶抗体阳性相关。ILD的存在将在很大程度上影响治疗反应和预后。
描述了在一家三级医院的肺部专科门诊接受监测的11例患有ASS且有肺部受累的患者。
9例患者抗Jo抗体阳性,2例抗PL12阳性。4例患者的高分辨率CT(HRCT)表现为非特异性间质性肺炎(NSIP),4例为寻常型间质性肺炎(UIP),1例为机化性肺炎(COP),2例为磨玻璃影。73%的患者伴有支气管扩张和细支气管扩张,27%有蜂窝样改变。功能检查主要受一氧化碳弥散量(DLCO)影响,高达45%的患者运动试验阳性。强调了皮质激素依赖,通常在慢性期和病情加重时都需要免疫抑制治疗。目前所有患者预后良好。
间质性肺病患者应至少检测抗合成酶抗体以识别该病,其预后比其他间质性疾病如特发性肺纤维化更好。