Glerup M, Herlin T, Twilt M
Department of Paediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Department of Paediatrics, division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada.
Clin Rheumatol. 2017 Mar;36(3):671-676. doi: 10.1007/s10067-017-3540-x. Epub 2017 Jan 17.
Recently, it has been hypothesized that the subcategories of the ILAR classification of juvenile idiopathic arthritis (JIA) are not homogeneous, and that the presence of antinuclear antibodies (ANA) should lead to a separate entity. Therefore, the aim of this study was to evaluate ANA positivity as a predictor of achieving remission. A retrospective single-center cohort study including all JIA patients diagnosed between January 2000 and May 2014. A minimum follow-up of 1 year was required plus the ANA status. ANA positivity was defined as at least two positive results with a titer ≥1:160. Demographic and clinical features were collected. Remission at last follow-up was defined by the Wallace criteria. A total of 625 patients met the inclusion criteria and 230 (37%) were found ANA positive. Analysis showed no difference in remission rate between ANA-positive and ANA-negative patients. Additionally, joint count at diagnosis and at last follow-up were comparable in both groups. ANA positivity was correlated to a female predominance and young age at diagnosis (p < 0.001). Remission rates are not different in ANA-positive patients than in ANA-negative patients. This does not support the hypothesis to possibly divide JIA patients based on their ANA status.
最近,有人提出假设,即国际风湿病联盟(ILAR)对幼年特发性关节炎(JIA)的分类亚类并非同质,且抗核抗体(ANA)的存在应导致一个独立的实体。因此,本研究的目的是评估ANA阳性作为实现缓解的预测指标。一项回顾性单中心队列研究,纳入了2000年1月至2014年5月期间诊断的所有JIA患者。要求至少随访1年并了解ANA状态。ANA阳性定义为至少两次阳性结果且滴度≥1:160。收集了人口统计学和临床特征。最后一次随访时的缓解情况根据华莱士标准定义。共有625例患者符合纳入标准,其中230例(37%)ANA呈阳性。分析显示,ANA阳性患者和ANA阴性患者的缓解率无差异。此外,两组在诊断时和最后一次随访时的关节计数具有可比性。ANA阳性与女性占优势以及诊断时年龄较小相关(p<0.001)。ANA阳性患者的缓解率与ANA阴性患者并无不同。这并不支持根据ANA状态对JIA患者进行分类的假设。