Tubach F, Hayem G, Elias A, Nicaise P, Haim T, Kahn M F, Meyer O
Rheumatology Department, Bichat Teaching Hospital, Paris, France.
Rev Rhum Engl Ed. 1997 Jun;64(6):362-7.
Anticentromere antibodies identified by indirect immunofluorescence are a valuable aid to the diagnosis and prognosis of patients with systemic sclerosis since they are associated in 50% to 80% of cases with limited cutaneous systemic sclerosis, a pattern usually associated with a good prognosis. We studied clinical presentations in rheumatology patients with anticentromere antibodies by indirect immunofluoresence and by ELISA and/or Western blot, but without scleroderma or Raynaud's phenomenon. Eight of 34 (23.5%) rheumatology clinic patients with centromere antibodies met these criteria, seven women and one man, with a median symptom duration of six years (range 1-20 years). Four had Sjögren's syndrome, one had isolated xerostomia, one systemic lupus erythematosus, one seronegative symmetric polyarthritis and one primary biliary cirrhosis with arthralgia. The mean anticentromere antibody titer in these eight patients was similar to that in the patients who had at least Raynaud's phenomenon. Given the low incidence of scleroderma, these data illustrate the poor predictive value of anticentromere antibodies for the diagnosis of scleroderma in rheumatology clinic patients.
通过间接免疫荧光法鉴定的抗着丝点抗体对系统性硬化症患者的诊断和预后有重要帮助，因为在50%至80%的病例中，它们与局限性皮肤型系统性硬化症相关，这种类型通常预后良好。我们通过间接免疫荧光法以及酶联免疫吸附测定法（ELISA）和/或蛋白质印迹法研究了患有抗着丝点抗体的风湿病患者的临床表现，但这些患者无硬皮病或雷诺现象。34名患有着丝点抗体的风湿病门诊患者中有8名（23.5%）符合这些标准，其中7名女性，1名男性，症状持续时间中位数为6年（范围1至20年）。4名患有干燥综合征，1名有单纯口干，1名有系统性红斑狼疮，1名有血清阴性对称性多关节炎，1名有原发性胆汁性肝硬化伴关节痛。这8名患者的抗着丝点抗体平均滴度与至少有雷诺现象的患者相似。鉴于硬皮病发病率较低，这些数据表明抗着丝点抗体在风湿病门诊患者中对硬皮病诊断的预测价值较差。
