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静脉注射丙种球蛋白致儿童抗核抗体异常的单中心研究。

A single-centre study on abnormal antinuclear antibodies in children caused by intravenous infusion of gamma globulin.

机构信息

Department of Rheumatology and Immunology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.

Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing, China.

出版信息

Front Immunol. 2024 Jul 18;15:1410661. doi: 10.3389/fimmu.2024.1410661. eCollection 2024.

Abstract

OBJECTIVE

To clarify the impact of intravenous infusion of gamma globulin (IVIg) on antinuclear antibodies (ANAs) in children.

METHODS

A retrospective analysis was performed on the data of children with nonspecific autoantibody-related diseases whose antinuclear antibody (ANA) and autoantibody profiles were detected in our hospital from January to March 2022. A total of 108 patients with a clear history of IVIg infusion within 28 days composed the IVIg group, and 1201 patients without a history of IVIg infusion composed the non-IVIg group.

RESULTS

All patients in the IVIg group had either positive ANAs or positive autoantibodies. Anti-SSA, anti-Ro52 and anti-AMA Mi2 were the top three autoantibodies in the IVIg group. The proportions of patients who were positive for either of these three autoantibodies in the IVIg group were significantly greater than those in the non-IVIg group (all P<0.5). Spearman correlation analysis revealed that the signal intensities of anti-SSA and anti-Ro52 were negatively correlated with the number of days of ANA detection after IVIg infusion (P<0.05). Multiple logistic analyses revealed that a greater total dosage of IVIg, greater IVIg per kilogram of body weight, and fewer ANA detection days after IVIg infusion were independent risk factors for positive anti-SSA and anti-Ro52 results.

CONCLUSIONS

It is recommended that if rheumatic diseases are suspected, ANA detection should be carried out beforeIVIg infusion. But for patients who are positive for at least one of these three autoantibodies after IVIg infusion, doctors should first consider adoptive antibodies.

摘要

目的

阐明静脉注射免疫球蛋白(IVIg)对儿童抗核抗体(ANA)的影响。

方法

对 2022 年 1 月至 3 月在我院检测抗核抗体(ANA)和自身抗体谱的非特异性自身抗体相关疾病患儿的资料进行回顾性分析。共纳入在 28 天内有明确 IVIg 输注史的患儿 108 例为 IVIg 组,无 IVIg 输注史的患儿 1201 例为非 IVIg 组。

结果

IVIg 组所有患儿均为 ANA 阳性或自身抗体阳性,其中抗 SSA、抗 Ro52 和抗 AMA Mi2 为前 3 位自身抗体,IVIg 组中这 3 种自身抗体任一种阳性的患儿比例均明显高于非 IVIg 组(均 P<0.05)。Spearman 相关分析显示,抗 SSA 和抗 Ro52 的信号强度与 IVIg 输注后 ANA 检测天数呈负相关(P<0.05)。多因素 logistic 分析显示,IVIg 总剂量、IVIg 每公斤体重剂量和 IVIg 输注后 ANA 检测天数是抗 SSA 和抗 Ro52 阳性的独立危险因素。

结论

建议在输注 IVIg 前进行 ANA 检测。但对于输注 IVIg 后至少有 1 种上述 3 种自身抗体阳性的患者,应首先考虑为适应性抗体。

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