ANA阴性Jo-1抗体阳性皮肌炎1例并文献复习

目的探讨抗核抗体谱检测在以间质性肺病为主要临床表现的皮肌炎诊断中的作用。方法回顾性分析1例被误诊为间质性肺炎、过敏性血管炎的皮肌炎患者的诊断及治疗过程,并结合自身抗体检测方法的特点及文献进行讨论。结果皮肌炎因常合并间质性肺病而被误诊,实验室可检测到自身抗体阳性,其中以抗核抗体(ANA)和Jo-1抗体阳性较为常见,是鉴别诊断的重要手段之一。但Jo-1抗体阳性也可出现在抗核抗体阴性的皮肌炎患者。结论对不明原因肺损害患者应考虑自身免疫性疾病的可能性,除了ANA以外,还应做抗核抗体谱的检测。

Dermatomyositis with antinuclear antibody(ANA)negative and anti Jo-1 positive: a case report and review of the literature

Objective To investigate the role of ANA profile test in the diagnosis of dermatomyositis(DM) with predominant pulmonary involvement.Methods One case of DM misdiagnosed as interstitial pneumonia and allergic angiitis was retrospectively analyzed.Combined with the characteristic of autoantibody assay in DM,the related literature was reviewed.Results DM is often complicated with interstitial lung disease(ILD) and misdiagnosed as interstitial pneumonia.Autoantibody-positive,especially both ANA and anti Jo-1 positive,is common in DM patients.Then ANA and anti Jo-1 test is useful in differential diagnosis of DM and interstitial pneumonia.Anti Jo-1 antibody can also be found in ANA negative DM patients.Conclusion General analysis of ANA profile other than ANA alone should be performed on patients with unexplained ILD.