Shenavandeh Saeedeh, Sadeghi Seyyed Mohammad Kazem, Aflaki Elham
Department of Internal Medicine, Division of Rheumatology, Shiraz University of Medical Science, Iran.
Reumatologia. 2021;59(5):302-308. doi: 10.5114/reum.2021.110567. Epub 2021 Nov 1.
The pathergy test (PT) is part of the diagnostic criteria of Behçet's disease (BD). Factors like needle character and number of punctures can affect the sensitivity of PT. We tried to compare its positivity using a thinner needle with and without self-saliva in active and inactive BD, recurrent aphthous stomatitis (RAS), and healthy people.
Twenty patients with active and 13 with inactive BD, 20 with RAS, and 34 healthy controls underwent 3 types of PT: 1 - the most recommended 20G dry needle PT, 2 - 23G dry needle PT, and 3 - 23G PT with self-saliva. The positivity and diagnostic accuracy of the tests between groups were compared.
All tests were negative in the normal healthy group. In active BD, the positivity of PT with self-saliva (70%) was higher than the 20G PT (20%) (-value = 0.004), being more correlated to disease activity (-value = 0.046). In the RAS group, there was no difference in the positivity of all tests (-value = 0.068). All tests had high diagnostic accuracy in discriminating between patients with active BD and the controls ( < 0.05). The pathergy test with self-saliva showed significant diagnostic accuracy in discriminating BD from non-BD participants ( < 0.001). The results of dry 23G PT were the same as those of 20G PT.
The self-saliva PT test was more positive in patients with active BD, correlated with disease activity, was more sensitive, had equal specificity in detecting BD from the control group, and was more sensitive but less specific in detecting BD, compared to the RAS group. The positivity and accuracy of dry 23G needle PT were the same as the 20G PT.Pathergy test with self-saliva using a thin (23G) needle is more sensitive has equal specificity in detecting patients with BD compared to the control group and is more sensitive but less specific in detecting the patients with BD compared to the RAS group. The positivity and accuracy of dry 23G needle PT is the same as the most recommended 20G dry PT. Pathergy test by wet 23G needle (with self-saliva) is more positive in patients with active BD compared to PT by dry 20G needle.
针刺反应试验（PT）是白塞病（BD）诊断标准的一部分。针的特性和穿刺次数等因素会影响PT的敏感性。我们试图比较在活动期和非活动期BD、复发性阿弗他口炎（RAS）以及健康人群中，使用较细针且有无自身唾液时PT的阳性率。
20例活动期BD患者、13例非活动期BD患者、20例RAS患者以及34名健康对照者接受了3种类型的PT：1 - 最推荐的20G干针PT，2 - 23G干针PT，3 - 23G自身唾液PT。比较了各组之间试验的阳性率和诊断准确性。
正常健康组所有试验均为阴性。在活动期BD中，自身唾液PT的阳性率（70%）高于20G PT（20%）（P值 = 0.004），且与疾病活动度相关性更强（P值 = 0.046）。在RAS组中，所有试验的阳性率无差异（P值 = 0.068）。所有试验在区分活动期BD患者和对照组方面具有较高的诊断准确性（P < 0.05）。自身唾液针刺反应试验在区分BD患者和非BD参与者方面显示出显著的诊断准确性（P < 0.001）。23G干针PT的结果与20G PT相同。
自身唾液PT试验在活动期BD患者中阳性率更高，与疾病活动度相关，更敏感，在与对照组比较时检测BD具有同等特异性，与RAS组比较时检测BD更敏感但特异性较低。23G干针PT的阳性率和准确性与20G PT相同。与对照组比较，使用细（23G）针进行自身唾液针刺反应试验在检测BD患者时更敏感且具有同等特异性，与RAS组比较时检测BD患者更敏感但特异性较低。23G干针PT的阳性率和准确性与最推荐的20G干针PT相同。与20G干针PT比较，23G湿针（加自身唾液）针刺反应试验在活动期BD患者中阳性率更高。
