ICAP
AC-4 - 细颗粒型
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同义词 细颗粒 fine granular
描述

细胞核呈现细颗粒样荧光,部分核仁阳性,分裂期细胞 (中期,后期和末期) 浓缩染色体阴性。例如抗SS-A/Ro, 抗SS-B/La。

Fine tiny speckles across all nucleoplasm. The nucleoli may be stained or not stained. Mitotic cells (metaphase, anaphase, and telophase) have the chromatin mass not stained. e.g. anti-SS-A/Ro, anti-SS-B/La

抗原相关性 SS-A/Ro, SS-B/La, Mi-2, TIF1γ, TIF1β, Ku SS-A/Ro, SS-B/La, Mi-2, TIF1γ, TIF1β, Ku
临床相关性
一级信息
关于临床相关性和缩写列表
Clinical Relevance
First level information
About Clinical Relevance & List of Abbreviations

►不同程度地存在于多种系统性自身免疫性风湿疾病中,特别是干燥综合征、系统性红斑狼疮、亚急性皮肤红斑狼疮、新生儿红斑狼疮、先天性心脏传导阻滞、皮肌炎、系统性硬化症和系统性硬化症-自身免疫性肌病重叠综合征(15)

►对于临床疑似干燥综合征、系统性红斑狼疮、亚急性皮肤性红斑狼疮、新生儿红斑狼疮或先天性心脏传导阻滞的患者,建议对抗SS-A/Ro(Ro60)和抗SS-B/La抗体进行后续筛查;在大多数实验室中,这些抗原都包含在常规的ENA谱检测中(15)

►抗SSA/Ro自身抗体是干燥综合征分类标准的一部分(标准不区分 Ro60和Ro52/TRIM21)(25)

►对于临床疑似系统性硬化症、自身免疫性肌病或较轻的系统性红斑狼疮的患者,建议进一步检测抗Mi-2、TIF1γ和Ku自身抗体;这些抗原通常包含在疾病特异性免疫检测(例如,炎症性肌病谱*)中(26)

►抗Mi-2和TIF1γ自身抗体与皮肌炎相关;皮肌炎患者中抗TIF1γ自身抗体虽然在所有的AC-4核型中很少见,但与老年患者的恶性肿瘤密切相关(26,27)

►抗Ku抗体与系统性硬化症-自身免疫性肌病重叠综合征和系统性红斑狼疮-系统性硬化症-自身免疫性肌病重叠综合征相关(26)

注:HEp-2间接免疫荧光检测中可能检测不到抗SS-A/Ro(Ro60)和自身免疫性肌病特异性自身抗体(28)

*炎症性肌病谱、系统性硬化症谱和(扩展的)肝病谱的应用可能仅限于专业的临床实验室。

► If SjS, SLE, subacute cutaneous lupus erythematosus, neonatal lupus erythematosus, or congenital heart block is clinically suspected, it is recommended to perform follow-up tests for anti-SS-A/Ro (Ro60) and anti-SS-B/La antibodies; in most laboratories these antigens are included in the routine ENA profile (15)

► Autoantibodies to SS-A/Ro are part of the classification criteria for SjS (the criteria do not distinguish between Ro60 and Ro52/TRIM21) (25)

► If SSc, AIM, or to a lesser extend SLE, is clinically suspected, it is recommended to perform follow-up tests for detecting autoantibodies to Mi-2, TIF1γ, and Ku; these antigens are typically included in disease specific immunoassays (i.e., inflammatory myopathy profile*) (26)

► Autoantibodies to Mi-2 and TIF1γ are associated with DM; autoantibodies to TIF1γ in patients with DM, although rare in the overall AC-4 pattern, is strongly associated with malignancy in old patients (26, 27)

► Autoantibodies to Ku are associated with SSc-AIM and SLE-SSc-AIM overlap syndromes (26)

Notes: Anti-SS-A/Ro (Ro60) and AIM-specific autoantibodies may be undetected in HEp-2 IIFA-screening (28)

*Availability of the inflammatory myopathy profile, the SSc profile and the (extended) liver profile may be limited to specialty clinical laboratories.


一级信息参考文献 First level information references

15. Conrad K, Schössler W, Hiepe F. Autoantibodies in systemic autoimmune diseases: a diagnostic reference. 2. 3th edn. Autoantigens autoantibodies autoimmunity, 2015.

25. Shiboski CH, Shiboski SC, Seror R, et al. American College of Rheumatology/European League against rheumatism classification criteria for primary Sjögren’s syndrome: a consensus and data-driven methodology involving three international patient cohorts. Ann Rheum Dis 2016;2017:9–16.

26. Betteridge Z, McHugh N. Myositis-specific autoantibodies: an important tool to support diagnosis of myositis. J Intern Med 2016;280:8–23.

27. Trallero-Araguás E, Rodrigo-Pendás JÁ, Selva-O’Callaghan A, et al. Usefulness of anti-p155 autoantibody for diagnosing cancer-associated dermatomyositis: a systematic review and meta-analysis. Arthritis Rheum 2012;64:523–32.

28. Bossuyt X, Frans J, Hendrickx A, et al. Detection of anti-SSA antibodies by indirect immunofluorescence. Clin Chem 2004;50:2361–9.


15. Conrad K, Schössler W, Hiepe F. Autoantibodies in systemic autoimmune diseases: a diagnostic reference. 2. 3th edn. Autoantigens autoantibodies autoimmunity, 2015.

25. Shiboski CH, Shiboski SC, Seror R, et al. American College of Rheumatology/European League against rheumatism classification criteria for primary Sjögren’s syndrome: a consensus and data-driven methodology involving three international patient cohorts. Ann Rheum Dis 2016;2017:9–16.

26. Betteridge Z, McHugh N. Myositis-specific autoantibodies: an important tool to support diagnosis of myositis. J Intern Med 2016;280:8–23.

27. Trallero-Araguás E, Rodrigo-Pendás JÁ, Selva-O’Callaghan A, et al. Usefulness of anti-p155 autoantibody for diagnosing cancer-associated dermatomyositis: a systematic review and meta-analysis. Arthritis Rheum 2012;64:523–32.

28. Bossuyt X, Frans J, Hendrickx A, et al. Detection of anti-SSA antibodies by indirect immunofluorescence. Clin Chem 2004;50:2361–9.


二级信息 Second level information


None

二级信息参考文献 Second level information references


None

FAQ

如何解释SS-A/ Ro60和SS-B/La阳性的样本在ANA中显示阴性。

 
 

Online since 19 May 2015