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关于在巨细胞激活综合征中进行抗体检测的学到的注意事项
Lawrence B Afrin1, Tania T Dempsey1, Gerhard J Molderings2
1AIM Center for Personalized Medicine, Purchase, NY, USA.
Diagnosis (Berlin, Germany)
|August 11, 2023
概括
大多数阳性抗体测试在巨细胞激活综合征 (MCAS) 患者是临床上无关紧要的模仿者,而不是真正的疾病标志物. 仔细分析趋势线至关重要,以避免对抗体相关疾病 (AAD) 的错误诊断.
科学领域:
- 免疫学 免疫学 免疫学
- 临床医学 临床医学
- 慢性炎症疾病 慢性炎症疾病
背景情况:
- 巨细胞激活综合征 (MCAS) 是一种普遍存在的,未被认可的慢性多系统炎症疾病.
- MCAS具有显著的临床异质性.
- 由于症状重叠和诊断标志物的误解可能性,准确的诊断具有挑战性.
研究的目的:
- 分析MCAS患者的抗体标位趋势线.
- 在MCAS中区分真正的致病性抗体和临床上无关紧要的抗体.
- 提供关于在MCAS中解释抗体测试的临床指导.
主要方法:
- 对104名MCAS患者的医疗记录进行了回顾性审查.
- 分析所有可用的抗体测试及其标位趋势线.
- 观察到的趋势线与抗体相关疾病 (AADs) 的预期模式的比较.
主要成果:
- 所有患者在不同点呈现出阳性/高抗体.
- 大多数阳性抗体被确定为临床上无意义的模仿剂,不表明特定的AADs.
- 观察到两种不同的抗体标位趋势线模式:一种是MCAS中的模仿剂,另一种是真正的AADs.
结论:
- 在MCAS患者中,阳性抗体测试经常代表由于免疫调节失调而造成的无意义的模仿者.
- 在MCAS中解释阳性抗体测试时建议谨慎,以防止AADs的错误诊断.
- 在诊断MCAS患者的AAD之前,建议耐心和仔细评估抗体趋势线.
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