Takenaka Sayaka, Ogura Takehisa, Oshima Hisaji, Izumi Keisuke, Hirata Ayako, Ito Hideki, Mizushina Kennosuke, Inoue Yuki, Katagiri Takaharu, Hayashi Norihide, Kameda Hideto
Division of Rheumatology, Department of Internal Medicine, Toho University, Tokyo, Japan.
Department of Connective Tissue Diseases, Tokyo Medical Center National Hospital Organization, Tokyo, Japan.
Mod Rheumatol. 2020 May;30(3):558-563. doi: 10.1080/14397595.2019.1619220. Epub 2019 Jun 4.
To examine the development and exacerbation of pulmonary nontuberculous mycobacterial (NTM) infection in patients with systemic autoimmune rheumatic diseases (SARD). We conducted a case-control study. Seventeen of 7013 patients with SARD fulfilling the criteria for pulmonary NTM infection were enrolled in the NTM group. The control group was matched for age, sex, and SARD at a ratio of 2:1. Eight patients with rheumatoid arthritis, four with systemic vasculitis, three with Sjögren's syndrome, and one each with dermatomyositis and systemic lupus erythematosus were included in the NTM group. was detected in 12 (71%) patients, in 2, and , , and in 1 patient each. Preexisting lung disease was more common in the NTM group than in the control group (88% versus 38%, = .0009), particularly bronchiectasis (65% versus 29%, = .033). The body mass index and serum albumin level were significantly lower in the NTM group than in the control group. Six patients (35%) experienced NTM exacerbation during observation. Clinical immune status at the time of NTM diagnosis, as indicated by the peripheral blood leukocyte/lymphocyte count and serum immunoglobulin G level, was unremarkable and comparable between patients with and without exacerbation, as were the treatments for SARD. In patients with SARD, pulmonary NTM infection may develop and exacerbate without clinically apparent immunosuppression.
为研究系统性自身免疫性风湿病（SARD）患者肺部非结核分枝杆菌（NTM）感染的发生及加重情况。我们进行了一项病例对照研究。7013例符合肺部NTM感染标准的SARD患者中有17例被纳入NTM组。对照组按2:1的比例在年龄、性别和SARD方面进行匹配。NTM组包括8例类风湿关节炎患者、4例系统性血管炎患者、3例干燥综合征患者以及各1例皮肌炎和系统性红斑狼疮患者。12例（71%）患者检测到[此处原文缺失具体检测项目]，2例检测到[此处原文缺失具体检测项目]，各有1例患者检测到[此处原文缺失具体检测项目]、[此处原文缺失具体检测项目]和[此处原文缺失具体检测项目]。NTM组中既往存在肺部疾病的情况比对照组更常见（88%对38%，P = 0.0009），尤其是支气管扩张（65%对29%，P = 0.033）。NTM组的体重指数和血清白蛋白水平显著低于对照组。6例患者（35%）在观察期间出现NTM病情加重。NTM诊断时的临床免疫状态，以外周血白细胞/淋巴细胞计数和血清免疫球蛋白G水平表示，无明显异常，且病情加重和未加重的患者之间具有可比性，SARD的治疗情况也是如此。在SARD患者中，肺部NTM感染可能在无明显临床免疫抑制的情况下发生并加重。
