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活动性结核病患者抗核抗体阳性的频率及其在抗结核治疗中的变化

Frequency of Positive Antinuclear Antibody in People With Active Tuberculosis and Its Changes With Antitubercular Therapy.

作者信息

Naher Naznin, Imam Hasan, Biswas Sunil Kumar, Biswas Tonmoy, Azad Mak, Hasan Md Nazmul

机构信息

Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD.

Department of Internal Medicine, Green Life Medical College and Hospital, Dhaka, BGD.

出版信息

Cureus. 2025 Mar 24;17(3):e81116. doi: 10.7759/cureus.81116. eCollection 2025 Mar.

DOI:10.7759/cureus.81116
PMID:40276432
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12018594/
Abstract

Background Tuberculosis (TB), one of the most prevalent chronic infectious diseases in our country, can disrupt immune function and induce autoantibodies such as antinuclear antibodies (ANAs). As ANA positivity occurs in both TB and autoimmune diseases such as systemic lupus erythematosus (SLE), it can complicate the diagnosis when symptoms overlap. Furthermore, it remains unclear whether ANA positivity resolves with successful TB treatment. This study aimed to assess the prevalence of ANA in active TB patients and evaluate changes in ANA status following anti-TB therapy. Methods This prospective observational study was conducted at the Bangabandhu Sheikh Mujib Medical University (BSMMU) and included 150 adult patients (≥18 years) with newly diagnosed active tuberculosis and no history of autoimmune diseases. ANA testing was performed at baseline, and repeat ANA testing was conducted after three and six months of anti-TB therapy. Qualitative data were summarised as numbers and percentages, with chi-square, t-test, and Mann-Whitney U applied as appropriate. Results A total of 13 out of 150 patients (8.7%) with active tuberculosis tested positive for ANAs. Among the 53 patients with pulmonary TB, six (11.3%) were ANA positive, while seven out of 97 patients (7.2%) with extrapulmonary TB tested ANA positive. The most common ANA pattern observed was the coarse speckled pattern, found in nine of the 13 ANA-positive patients (69.23%). After six months of antitubercular therapy, 12 out of the 13 initially ANA-positive patients (92.3%) became ANA negative. Conclusion Positive ANA antibodies were detected in pulmonary TB patients as well as in extrapulmonary TB patients. However, no significant associations were found between antinuclear antibodies and active tuberculosis.

摘要

背景

结核病是我国最常见的慢性传染病之一,可破坏免疫功能并诱导自身抗体产生,如抗核抗体(ANA)。由于ANA阳性在结核病和自身免疫性疾病(如系统性红斑狼疮,SLE)中均有出现,当症状重叠时会使诊断变得复杂。此外,目前尚不清楚ANA阳性是否会随着结核病的成功治疗而消失。本研究旨在评估活动性结核病患者中ANA的患病率,并评估抗结核治疗后ANA状态的变化。

方法

本前瞻性观察性研究在孟加拉国谢赫穆吉布医学大学(BSMMU)进行,纳入了150名成年患者(≥18岁),这些患者新诊断为活动性结核病且无自身免疫性疾病史。在基线时进行ANA检测,并在抗结核治疗3个月和6个月后重复进行ANA检测。定性数据以数字和百分比汇总,根据情况应用卡方检验、t检验和曼-惠特尼U检验。

结果

150例活动性结核病患者中共有13例(8.7%)ANA检测呈阳性。在53例肺结核患者中,6例(11.3%)ANA呈阳性,而97例肺外结核患者中有7例(7.2%)ANA呈阳性。观察到的最常见ANA模式是粗颗粒型,在13例ANA阳性患者中有9例(69.23%)出现。抗结核治疗6个月后,13例最初ANA阳性的患者中有12例(92.3%)ANA转为阴性。

结论

在肺结核患者和肺外结核患者中均检测到ANA抗体阳性。然而,未发现抗核抗体与活动性结核病之间存在显著关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2c5/12018594/5c4ebde44730/cureus-0017-00000081116-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2c5/12018594/5c4ebde44730/cureus-0017-00000081116-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2c5/12018594/5c4ebde44730/cureus-0017-00000081116-i01.jpg

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本文引用的文献

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J Assoc Physicians India. 2022 Nov;70(11):11-12. doi: 10.5005/japi-11001-0126.
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The increasing prevalence of autoimmunity and autoimmune diseases: an urgent call to action for improved understanding, diagnosis, treatment, and prevention.自身免疫和自身免疫性疾病的患病率不断上升:急需采取行动以提高认识、诊断、治疗和预防水平。
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Tuberculosis and Autoimmunity.
结核病与自身免疫
Pathophysiology. 2022 Jun 13;29(2):298-318. doi: 10.3390/pathophysiology29020022.
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Autoantibodies to Tumor Necrosis Factor in Patients with Active Pulmonary Tuberculosis.
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Prevalence of Auto-antibodies in Pulmonary Tuberculosis.肺结核中自身抗体的患病率
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