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日本抗中性粒细胞胞质抗体相关性眼表疾病 18 例临床回顾

Anti-Neutrophil Cytoplasmic Antibody-Associated Ocular Manifestations in Japan: A Review of 18 Patients.

机构信息

Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Department of Ophthalmology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.

出版信息

Ocul Immunol Inflamm. 2021 Jul 4;29(5):991-996. doi: 10.1080/09273948.2020.1712432. Epub 2020 Feb 20.

Abstract

ABSTARCT

To investigate ocular manifestations in patients positive for serum anti-neutrophil cytoplasmic antibodies (ANCAs) in Japan.: The clinical records of patients who had ocular manifestations and who were serum ANCA positive between 2011-2017 at Tokyo Medical and Dental University Hospital were retrospectively reviewed.: Eighteen patients were identified to be positive for serum ANCA and had ocular manifestations, including optic nerve involvement (50%), scleritis (27.8%), iritis (27.8%), retinal vasculitis (16.7%), oculomotor disorder (16.7%), and peripheral ulcerative keratitis (11.1%). Six patients had ANCA-associated vasculitis (AAV), including 5 patients with granulomatosis with polyangiitis and 1 patient with microscopic polyangiitis. Most patients with optic nerve involvement were myeloperoxidase-ANCA positive. Contrastingly, most patients with anterior segment involvement were proteinase-3-ANCA positive.: Ocular manifestations were observed in some patients positive for serum ANCAs. Serum ANCA evaluation is useful for identifying the etiology of ocular inflammation and for diagnosing AAV, a life-threatening disease.

摘要

摘要

目的:调查日本血清抗中性粒细胞胞浆抗体(ANCA)阳性患者的眼部表现。方法:回顾性分析 2011 年至 2017 年在东京医科齿科大学医院就诊的血清 ANCA 阳性且有眼部表现的患者的临床资料。结果:共发现 18 例血清 ANCA 阳性且有眼部表现的患者,包括视神经受累(50%)、巩膜炎(27.8%)、虹膜炎(27.8%)、视网膜血管炎(16.7%)、眼外肌障碍(16.7%)和周边溃疡性角膜炎(11.1%)。6 例患者为抗中性粒细胞胞浆抗体相关血管炎(AAV),包括 5 例肉芽肿性多血管炎和 1 例显微镜下多血管炎。视神经受累患者多数为髓过氧化物酶-ANCA 阳性。相反,前节受累患者多数为蛋白酶 3-ANCA 阳性。结论:一些血清 ANCA 阳性患者出现眼部表现。血清 ANCA 评估有助于确定眼部炎症的病因,并诊断危及生命的 AAV。

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