AIM: Anti-Saccharomyces cerevisiae antibodies (ASCA), anti-nuclear associated anti-neutrophil antibodies (NANA) and antibodies to exocrine pancreas (PAB), are serological tools for discriminating Crohn’s disease (CrD...AIM: Anti-Saccharomyces cerevisiae antibodies (ASCA), anti-nuclear associated anti-neutrophil antibodies (NANA) and antibodies to exocrine pancreas (PAB), are serological tools for discriminating Crohn’s disease (CrD) and ulcerative colitis (UC). Like CrD, coeliac disease (CoD) is an inflammatory bowel disease (IBD) associated with (auto) antibodies. Performing a multicenter study we primarily aimed to determine the performance of ASCA, NANA and PAB tests for IBD diagnosis in children and adults, and secondarily to evaluate the prevalence of these markers in CoD. METHODS: Sera of 109 patients with CrD, 78 with UC, 45 with CoD and 50 healthy blood donors were retrospectively included. ASCA, NANA and PAB were detected by indirect immunofluorescence (IIF). RESULTS: ASCA+/NANA- profile displayed a positive predictive value of 94.2% for CrD. Detection of ASCA was correlated with a more severe clinical profile of CrD and treatment of the disease did not influence their serum levels. ASCA positivity was found in 37.9% of active CoD.PAB were found in 36.7% CrD and 13.3% CoD patients and were not correlated with clinical features of CrD, except with an early onset of the disease. Fifteen CrD patients were ASCA negative and PAB positive. CONCLUSION: ASCA and PAB detected by IIF are specific markers for CrD although their presence does not rule out a possible active CoD. The combination of ASCA, NANA and PAB tests improves the sensitivity of immunological markers for CrD. Repeating ASCA, NANA, and PAB testing during the course of CrD has no clinical value.展开更多
The differential diagnosis of Behcet's disease(BD) from inflammatory bowel disease(IBD) is sometimes difficult and challenging.Hereby,we suggested the utility of anti-saccharomyces cerevisiae antibody(ASCA) and an...The differential diagnosis of Behcet's disease(BD) from inflammatory bowel disease(IBD) is sometimes difficult and challenging.Hereby,we suggested the utility of anti-saccharomyces cerevisiae antibody(ASCA) and anti-neutrophilic cytoplasmic antibody(p-ANCA) in the differential diagnosis of BD from IBD.展开更多
Objectives: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune disease usually seen in middle-aged and older adults but which is rare in children and adolescents. We sought to determine...Objectives: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune disease usually seen in middle-aged and older adults but which is rare in children and adolescents. We sought to determine if there has been a change in the incidence of this disorder. Methods: Single-center, retrospective review. Results: Over the last 2 years, we have encountered a striking increase in the frequency of this disease in pediatric patients. All eight patients seen during this period had renal involvement and 5 patients rapidly progressed to end stage kidney disease. The prognosis was worse in younger patients, those with microscopic polyangiitis, and those with chronic kidney damage in the diagnostic renal biopsy. Conclusions: We report these observations to highlight this change in the epidemiology of ANCA-associated vasculitis and to promote earlier recognition and treatment of this severe form of glomerulonephritis.展开更多
目的:通过对比免疫相关不良反应(irAE)发生前后血常规中主要指标的变化,为鉴别诊断irAE及感染性炎症提供新依据。方法:回顾性分析201例2018年8月至2022年6月在河南省肿瘤医院接受抗PD-1抗体治疗后出现irAE的肿瘤患者的临床资料,包括抗P...目的:通过对比免疫相关不良反应(irAE)发生前后血常规中主要指标的变化,为鉴别诊断irAE及感染性炎症提供新依据。方法:回顾性分析201例2018年8月至2022年6月在河南省肿瘤医院接受抗PD-1抗体治疗后出现irAE的肿瘤患者的临床资料,包括抗PD-1抗体治疗前、发生irAE前及irAE后血常规的主要指标,采用配对t检验分析治疗前后血常规指标值的统计学差异。采用定性变量的配对χ^(2)检验分析治疗前后血常规指标值的阳性率(高于正常值的比例)的统计学差异。结果:从201例患者中观察到了258次irAE,其中27例(13.4%)患者发生了2种及以上类型的irAE,214次(82.94%)irAE未引起发热;irAE发生后与抗PD-1抗体治疗前相比,白细胞计数(t=1.087,P=0.278)、中性粒细胞计数(t=0.959,P=0.338)及中性粒细胞百分比(t=0.817,P=0.414)未见明显升高,且三指标高于正常值的病例数分别为28 vs 38(χ^(2)=1.737,P=0.187)、32 vs 44(χ^(2)=2.222,P=0.136)、45 vs 55(χ^(2)=1.240,P=0.265),差异均无统计学意义。结论:irAE发生后患者外周血白细胞计数、中性粒细胞计数及中性粒细胞百分比无明显变化,这对鉴别诊断感染性炎症可能具有参考意义。展开更多
目的探讨基质金属蛋白酶-9(MMP-9)、抗内皮细胞抗体(AECA)和抗中性粒细胞胞质抗体(ANCA)在川崎病(KD)冠状动脉损害中的作用及临床意义。方法选取KD患儿42例,分为冠脉损害(CAL)组16例,无冠脉损害(NCAL)组26例,以20例普通发热患儿、15例...目的探讨基质金属蛋白酶-9(MMP-9)、抗内皮细胞抗体(AECA)和抗中性粒细胞胞质抗体(ANCA)在川崎病(KD)冠状动脉损害中的作用及临床意义。方法选取KD患儿42例,分为冠脉损害(CAL)组16例,无冠脉损害(NCAL)组26例,以20例普通发热患儿、15例择期手术患儿作为对照组。ELISA检测各组血清MMP-9、AECA和ANCA蛋白水平;荧光定量PCR、明胶酶谱法分别测定单个核细胞MMP-9 m RNA表达及血清MMP-9酶活性。结果 KD急性期外周血MMP-9 m RNA表达、蛋白水平及酶活性均高于两对照组(P均<0.01),CAL组较NCAL组升高更显著(P均<0.05)。KD缓解期MMP-9 m RNA表达、蛋白水平及酶活性较急性期降低(P均<0.01)。KD急性期AECA、ANCA蛋白水平均高于两对照组(P均<0.01)。CAL组ANCA蛋白水平高于NCAL组(P<0.01)。KD急性期血清AECA水平与MMP-9呈正相关(r=0.77,P<0.01)。急性期CAL组MMP-9、ANCA与冠状动脉内径/主动脉瓣环内径比值呈正相关关系(r=0.57,P<0.05;r=0.88,P<0.01)。结果 MMP-9、AECA、ANCA蛋白参与KD血管炎及冠脉损害过程,检测其血清水平对早期预测冠脉损害有一定价值。展开更多
目的嗜酸性肉芽肿性多血管炎(eosinophilic granulomatosis with polyangiitis,EGPA)中以血管炎为主要特征和以嗜酸性粒细胞浸润为主要特征的两种亚型分类标准尚未明确,本研究探讨EGPA两种亚型的准确、简明分类方式。方法回顾性收集2000...目的嗜酸性肉芽肿性多血管炎(eosinophilic granulomatosis with polyangiitis,EGPA)中以血管炎为主要特征和以嗜酸性粒细胞浸润为主要特征的两种亚型分类标准尚未明确,本研究探讨EGPA两种亚型的准确、简明分类方式。方法回顾性收集2000年1月—2023年11月北京协和医院呼吸内科、全科医学科、风湿免疫科等多科确诊的EGPA患者临床资料,将患者根据单纯抗中性粒细胞胞浆抗体(antineutrophil cytoplasmic antibodies,ANCA)、ANCA与组织病理活检结果相结合以及MIRRA标准三种分类方法分为不同的阳性组和阴性组,分析患者的临床特征。结果共纳入245例患者。根据ANCA结果分类时,阳性组51例,阴性组194例,相较于阴性组,阳性组患者的年龄(60.9比55.4)、NEUT%(59.12比51.87)、PLT(312.94比264.64)、ESR(55.40比27.62)、CRP(46.51比23.57)均较高,上述指标均达显著统计学意义;阳性组肾脏系统(47.1%比25.8%)和神经系统(72.5%比58.2%)的受累比例也显著高于阴性组。根据ANCA结果和组织病理活检结果分类时,阳性组88例,阴性组157例,两组间的分析结果与第一种分类方法一致。根据MIRRA标准分类时,MIRRA标准组患者161例,MIRRA非标准组患者84例,MIRRA标准组的NEUT%(55.39比49.58)显著高于MIRRA非标准组,而LY%(18.57比21.30)和HGB(128.80比136.36)显著低于MIRRA非标准组。结论根据ANCA结果可将EGPA患者分为血管炎亚型和嗜酸性粒细胞浸润亚型;尽管ANCA联合组织病理活检结果也可明确区分血管炎亚型与嗜酸性粒细胞浸润亚型,但由于病理活检存在风险,需根据患者的具体情况进行个体化评估;而MIRRA标准不能准确区分两类亚型。展开更多
文摘AIM: Anti-Saccharomyces cerevisiae antibodies (ASCA), anti-nuclear associated anti-neutrophil antibodies (NANA) and antibodies to exocrine pancreas (PAB), are serological tools for discriminating Crohn’s disease (CrD) and ulcerative colitis (UC). Like CrD, coeliac disease (CoD) is an inflammatory bowel disease (IBD) associated with (auto) antibodies. Performing a multicenter study we primarily aimed to determine the performance of ASCA, NANA and PAB tests for IBD diagnosis in children and adults, and secondarily to evaluate the prevalence of these markers in CoD. METHODS: Sera of 109 patients with CrD, 78 with UC, 45 with CoD and 50 healthy blood donors were retrospectively included. ASCA, NANA and PAB were detected by indirect immunofluorescence (IIF). RESULTS: ASCA+/NANA- profile displayed a positive predictive value of 94.2% for CrD. Detection of ASCA was correlated with a more severe clinical profile of CrD and treatment of the disease did not influence their serum levels. ASCA positivity was found in 37.9% of active CoD.PAB were found in 36.7% CrD and 13.3% CoD patients and were not correlated with clinical features of CrD, except with an early onset of the disease. Fifteen CrD patients were ASCA negative and PAB positive. CONCLUSION: ASCA and PAB detected by IIF are specific markers for CrD although their presence does not rule out a possible active CoD. The combination of ASCA, NANA and PAB tests improves the sensitivity of immunological markers for CrD. Repeating ASCA, NANA, and PAB testing during the course of CrD has no clinical value.
文摘The differential diagnosis of Behcet's disease(BD) from inflammatory bowel disease(IBD) is sometimes difficult and challenging.Hereby,we suggested the utility of anti-saccharomyces cerevisiae antibody(ASCA) and anti-neutrophilic cytoplasmic antibody(p-ANCA) in the differential diagnosis of BD from IBD.
文摘Objectives: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune disease usually seen in middle-aged and older adults but which is rare in children and adolescents. We sought to determine if there has been a change in the incidence of this disorder. Methods: Single-center, retrospective review. Results: Over the last 2 years, we have encountered a striking increase in the frequency of this disease in pediatric patients. All eight patients seen during this period had renal involvement and 5 patients rapidly progressed to end stage kidney disease. The prognosis was worse in younger patients, those with microscopic polyangiitis, and those with chronic kidney damage in the diagnostic renal biopsy. Conclusions: We report these observations to highlight this change in the epidemiology of ANCA-associated vasculitis and to promote earlier recognition and treatment of this severe form of glomerulonephritis.
文摘目的:通过对比免疫相关不良反应(irAE)发生前后血常规中主要指标的变化,为鉴别诊断irAE及感染性炎症提供新依据。方法:回顾性分析201例2018年8月至2022年6月在河南省肿瘤医院接受抗PD-1抗体治疗后出现irAE的肿瘤患者的临床资料,包括抗PD-1抗体治疗前、发生irAE前及irAE后血常规的主要指标,采用配对t检验分析治疗前后血常规指标值的统计学差异。采用定性变量的配对χ^(2)检验分析治疗前后血常规指标值的阳性率(高于正常值的比例)的统计学差异。结果:从201例患者中观察到了258次irAE,其中27例(13.4%)患者发生了2种及以上类型的irAE,214次(82.94%)irAE未引起发热;irAE发生后与抗PD-1抗体治疗前相比,白细胞计数(t=1.087,P=0.278)、中性粒细胞计数(t=0.959,P=0.338)及中性粒细胞百分比(t=0.817,P=0.414)未见明显升高,且三指标高于正常值的病例数分别为28 vs 38(χ^(2)=1.737,P=0.187)、32 vs 44(χ^(2)=2.222,P=0.136)、45 vs 55(χ^(2)=1.240,P=0.265),差异均无统计学意义。结论:irAE发生后患者外周血白细胞计数、中性粒细胞计数及中性粒细胞百分比无明显变化,这对鉴别诊断感染性炎症可能具有参考意义。
文摘目的探讨基质金属蛋白酶-9(MMP-9)、抗内皮细胞抗体(AECA)和抗中性粒细胞胞质抗体(ANCA)在川崎病(KD)冠状动脉损害中的作用及临床意义。方法选取KD患儿42例,分为冠脉损害(CAL)组16例,无冠脉损害(NCAL)组26例,以20例普通发热患儿、15例择期手术患儿作为对照组。ELISA检测各组血清MMP-9、AECA和ANCA蛋白水平;荧光定量PCR、明胶酶谱法分别测定单个核细胞MMP-9 m RNA表达及血清MMP-9酶活性。结果 KD急性期外周血MMP-9 m RNA表达、蛋白水平及酶活性均高于两对照组(P均<0.01),CAL组较NCAL组升高更显著(P均<0.05)。KD缓解期MMP-9 m RNA表达、蛋白水平及酶活性较急性期降低(P均<0.01)。KD急性期AECA、ANCA蛋白水平均高于两对照组(P均<0.01)。CAL组ANCA蛋白水平高于NCAL组(P<0.01)。KD急性期血清AECA水平与MMP-9呈正相关(r=0.77,P<0.01)。急性期CAL组MMP-9、ANCA与冠状动脉内径/主动脉瓣环内径比值呈正相关关系(r=0.57,P<0.05;r=0.88,P<0.01)。结果 MMP-9、AECA、ANCA蛋白参与KD血管炎及冠脉损害过程,检测其血清水平对早期预测冠脉损害有一定价值。
