Basha Aseem, Rawat Amit, Jindal Ankur K, Gupta Anju, Anand Shashi, Garg Ravinder, Minz Ranjana W, Singh Surjit
Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Int J Rheum Dis. 2018 Nov;21(11):2036-2040. doi: 10.1111/1756-185X.13372. Epub 2018 Aug 30.
To study the profile of autoantibodies on long-term follow-up of children with Kawasaki disease (KD).
In this single-center observational cohort study, 50 children who had been diagnosed and treated for KD with a minimum follow-up period of 3 years were enrolled. The organ-specific autoantibodies that were assessed in the study included anti-thyroid microsomal antibody (TMA), anti-parietal cell antibody (PCA) and anti-liver kidney microsomal (LKM) antibody. The organ-nonspecific autoantibodies that were studied included anti-endothelial cell antibody (AECA), anti-nuclear antibody (ANA), anti-neutrophil cytoplasmic antibody (ANCA), anti-mitochondrial antibody (AMA) and anti-smooth muscle antibody (SMA).
The sample for assessment of serology was taken at a mean follow-up period of 6.41 years (±1.95 SD) after diagnosis. Autoantibodies were detected in 11/50 (22%) patients. ANA was detected in three patients, TMA was positive in seven and ANCA was positive in one.
These autoantibodies likely develop in children with KD during the acute stage and may persist for many years. There is no concrete evidence to suggest that these children are at increased risk of developing an autoimmune disease in the future. However, there is some justification for prolonged surveillance for development of autoimmune manifestations.
研究川崎病(KD)患儿长期随访中的自身抗体情况。
在这项单中心观察性队列研究中,纳入了50例已确诊并接受KD治疗且随访期至少3年的患儿。研究中评估的器官特异性自身抗体包括抗甲状腺微粒体抗体(TMA)、抗壁细胞抗体(PCA)和抗肝肾微粒体(LKM)抗体。研究的器官非特异性自身抗体包括抗内皮细胞抗体(AECA)、抗核抗体(ANA)、抗中性粒细胞胞浆抗体(ANCA)、抗线粒体抗体(AMA)和抗平滑肌抗体(SMA)。
诊断后平均随访6.41年(±1.95标准差)时采集血清学评估样本。50例患者中有11例(22%)检测到自身抗体。3例患者检测到ANA,7例TMA呈阳性,1例ANCA呈阳性。
这些自身抗体可能在KD患儿急性期产生,并可能持续多年。没有确凿证据表明这些患儿未来患自身免疫性疾病的风险增加。然而,对自身免疫表现的发生进行长期监测有一定的合理性。