Mulani Shaunak, McNish Sean, Jones Derek, Shanmugam Victoria K
Division of Rheumatology, School of Medicine and Health Sciences, Ideas to Health Laboratory, The George Washington University, Washington, District of Columbia, USA.
Int J Rheum Dis. 2018 May;21(5):1018-1022. doi: 10.1111/1756-185X.13312.
The purpose of this study was to investigate the prevalence of antinuclear antibody (ANA) positivity in a cohort of patients with hidradenitis suppurativa (HS), and to assess the frequency of seroconversion during treatment with tumor necrosis factor (TNF)-α inhibitor therapy.
This prospective study was conducted through the Wound Etiology and Healing (WE-HEAL) Study. Immunofluorescence ANA testing was performed at baseline, and repeated when clinically indicated. ANA titers of ≥1 : 160 were considered positive. Data were collected on demographics and disease activity scores including the Hurley stage, the HS Sartorius score (HSS) and the active nodule (AN) count.
At the time of data lock, 73 patients with a confirmed diagnosis of HS were enrolled, and four (5.4%) had baseline positive ANA. None of the patients had clinical evidence of systemic lupus erythematosus or other autoimmune diseases. There were no significant differences in demographics, baseline HSS (43.25 ± 47.55 compared to 59.48 ± 56.67, P = 0.58) or AN count (3.25 ± 3.20 compared to 3.45 ± 2.36, P = 0.87) in the ANA positive group. Of the 69 patients who were ANA negative at enrollment, 31 (45%) received TNF-α inhibitor therapy. During follow up, one patient developed drug-induced lupus secondary to TNF-α inhibitor use. Additionally, one patient seroconverted to ANA positive without sequelae and one patient developed drug-induced hepatitis secondary to TNF-α inhibitor use.
The prevalence of baseline ANA positivity in this HS population was similar to that seen in the general population (5.4%). The rate of seroconversion and drug-induced complications in this population were low.
本研究旨在调查化脓性汗腺炎(HS)患者队列中抗核抗体(ANA)阳性的患病率,并评估肿瘤坏死因子(TNF)-α抑制剂治疗期间血清转化的频率。
本前瞻性研究通过伤口病因与愈合(WE-HEAL)研究进行。在基线时进行免疫荧光ANA检测,并在临床需要时重复检测。ANA滴度≥1:160被视为阳性。收集了人口统计学和疾病活动评分数据,包括Hurley分期、HS缝匠肌评分(HSS)和活动性结节(AN)计数。
在数据锁定时,纳入了73例确诊为HS的患者,其中4例(5.4%)基线ANA阳性。所有患者均无系统性红斑狼疮或其他自身免疫性疾病的临床证据。ANA阳性组在人口统计学、基线HSS(43.25±47.55与59.48±56.67相比,P=0.58)或AN计数(3.25±3.20与3.45±2.36相比,P=0.87)方面无显著差异。在入组时ANA阴性的69例患者中,31例(45%)接受了TNF-α抑制剂治疗。在随访期间,1例患者因使用TNF-α抑制剂继发药物性狼疮。此外,1例患者血清转化为ANA阳性且无后遗症,1例患者因使用TNF-α抑制剂继发药物性肝炎。
该HS人群中基线ANA阳性的患病率与普通人群相似(5.4%)。该人群中血清转化和药物诱导并发症的发生率较低。