Predicting cardiopulmonary involvement in patients with systemic sclerosis: complementary value of nailfold videocapillaroscopy patterns and disease-specific autoantibodies
| Autor: | Schippers Hpc, J. Meijs, Huizinga Twj, Ajmone Marsan N, Anne A. Schouffoer, de Vries-Bouwstra Jk, Markusse Im, Maarten K. Ninaber, de Boer B, Kroft Ljm, Jaap A. Bakker |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Lung Diseases
Male Databases Factual systemic sclerosis autoantibodies Comorbidity 030204 cardiovascular system & hematology Logistic regression Gastroenterology Microscopic Angioscopy 0302 clinical medicine Prevalence Pharmacology (medical) Netherlands Interstitial lung disease Middle Aged medicine.anatomical_structure cardiopulmonary involvement Cardiovascular Diseases Disease Progression Female Adult medicine.medical_specialty Risk Assessment 03 medical and health sciences Age Distribution Rheumatology Antigen Predictive Value of Tests Internal medicine medicine.artery medicine Humans Sex Distribution Retrospective Studies 030203 arthritis & rheumatology Scleroderma Systemic Lung business.industry nailfold videocapillaroscopy screening Microangiopathy Autoantibody anti-ENA Odds ratio medicine.disease Cross-Sectional Studies Logistic Models Nails Multivariate Analysis Immunology Pulmonary artery business |
| Zdroj: | Rheumatology, 56(7), 1081-1088 Europe PubMed Central |
| Popis: | Objective To evaluate the prevalence of anti-extractable nuclear antigen (anti-ENA) antibodies in Dutch SSc patients and the predictive power of the combination of specific anti-ENA antibodies and nailfold videocapillaroscopy (NVC) patterns to improve identification of patients with high risk for cardiopulmonary involvement. Methods A total of 287 patients (79%) from the Leiden SSc-Cohort had data available on NVC-pattern (no SSc-specific, early, active, late) and anti-ENA antibodies. Associations between anti-ENA/NVC combinations with cardiopulmonary parameters were explored using logistic regression. Results Prevalence of ACA was 37%, anti-Scl-70 24%, anti-RNP 9%, anti-RNAPIII 5%, anti-fibrillarin 4%, anti-Pm/Scl 3%, anti-Th/To 0.3% and anti-Ku 1.4%. NVC showed a SSc-specific pattern in 88%: 10% early, 42% active and 36% late. The prevalence of different NVC patterns was equally distributed among specific anti-ENA antibodies, except for the absence of early pattern in anti-RNP positive patients. Fifty-one percent had interstitial lung disease (ILD), 59% had decreased diffusion capacity for carbon monoxide and 16% systolic pulmonary artery pressure >35 mmHg (sPAP↑). Regardless of ENA-subtype, NVC-pattern showed a stable association with presence of ILD or sPAP↑. For ILD, the odds ratios (ORs) were 1.3-1.4 ( P < 0.05 for analyses with anti-RNAPIII, anti-RNP). For diffusion capacity for carbon monoxide, the OR was 1.5 ( P < 0.05 for analyses with ACA, anti-Scl-70, anti-RNAPIII, anti-RNP). For sPAP↑, the ORs were 2.2-2.4 ( P < 0.05 for analyses with anti-RNAPIII, anti-RNP). Conclusion In Dutch SSc patients, all SSc-specific auto-antibodies were found, with ACA and anti-Scl-70 being the most prevalent. Strikingly, the association between NVC-pattern and heart/lung involvement was independent of specific anti-ENA antibodies, which might indicate microangiopathy is an important cause of organ involvement. |
| Databáze: | OpenAIRE |
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