Department of Dermatology, University Hospital Muenster, Münster, Germany.
Central Laboratory, University Hospital Muenster, Münster, Germany.
J Dtsch Dermatol Ges. 2023 May;21(5):464-470. doi: 10.1111/ddg.15022. Epub 2023 Mar 15.
Antinuclear antibodies (ANA) detected by HEp2 cell immunofluorescence staining are a characteristic finding in patients with connective tissue disease (CTD). However, even detection of highly elevated ANA is not conclusive for CTD and can result in misdiagnosis. Anti-DFS70 antibodies are ANA, which may also be highly elevated in people without CTD. Thus, we wanted to evaluate whether they could cause misdiagnosis of CTD. Since anti-DSF70 antibodies have been associated with atopic dermatitis (AD) in Japan, we wanted to investigate this association and its potential diagnostic relevance in Germany.
We retrospectively analyzed data of 40 patients referred for first consultation on CTD and prospectively analyzed the prevalence of anti-DFS70 antibodies in 110 AD patients and 89 controls.
We could not confirm CTD in 75% of our referred patients, 26% of whom had already received systemic treatments. DFS70-typical fluorescence staining was detected in 35% and definitive anti-DFS70 antibodies in 12.5% of these patients. DFS70-typical fluorescence staining was detected in 22% of AD patients and anti-DFS70 antibodies in 10% (versus 5.6% and 0% in control patients, P < 0.001).
Anti-DFS70 antibodies are significantly associated with AD and could be responsible for misdiagnosis of CTD.
抗核抗体（ANA）通过 HEp2 细胞免疫荧光染色检测是结缔组织病（CTD）患者的特征性发现。然而，即使检测到高度升高的 ANA 也不能明确诊断 CTD，可能导致误诊。抗 DFS70 抗体也是 ANA，在没有 CTD 的人群中也可能高度升高。因此，我们想评估它们是否会导致 CTD 的误诊。由于抗 DFS70 抗体与日本特应性皮炎（AD）有关，我们想在德国研究这种关联及其潜在的诊断相关性。
我们回顾性分析了 40 名因 CTD 初诊而转介的患者的数据，并前瞻性分析了 110 例 AD 患者和 89 例对照者中抗 DFS70 抗体的患病率。
我们无法确诊我们转介的患者中有 75%的患者患有 CTD，其中 26%的患者已经接受了系统治疗。在这些患者中，35%出现了 DFS70 典型荧光染色，12.5%出现了明确的抗 DFS70 抗体。在 22%的 AD 患者中检测到了 DFS70 典型荧光染色，在 10%的患者中检测到了抗 DFS70 抗体（而对照组患者中分别为 5.6%和 0%，P<0.001）。
抗 DFS70 抗体与 AD 显著相关，可能导致 CTD 的误诊。
