Anti-Ro(SS-A) autoantibodies in central nervous system disease associated with Sjögren's syndrome (CNS-SS): clinical, neuroimaging, and angiographic correlates
Autor: | Nicholas J. Patronas, M. R. Ranzenbach, W. E. Kozachuk, Elaine L. Alexander, Ashok J. Kumar, Morris Reichlin, John B. Harley, A. E. Rosenbaum |
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Rok vydání: | 1994 |
Předmět: |
Pathology
medicine.medical_specialty Systemic disease Ischemia Autoantigens Angiopathy Central nervous system disease Neuroimaging RNA Small Cytoplasmic medicine Humans Vascular Diseases Autoantibodies Autoimmune disease Inflammation Brain Diseases medicine.diagnostic_test business.industry Autoantibody medicine.disease Magnetic Resonance Imaging Cerebral Angiography Sjogren's Syndrome Ribonucleoproteins Neurology (clinical) business Cerebral angiography |
Zdroj: | Neurology. 44(5) |
ISSN: | 0028-3878 |
Popis: | Objective: To examine in Sjogren9s syndrome (SS) the interrelationship between the presence of the anti-Ro(SS-A) antibody response and (1) concomitant presence and type (ie, focal or nonfocal) of CNS disease (CNS-SS), (2) cross-sectional brain MRI or CT, and (3) abnormal cerebral angiography. Methods: Neurologic, neuroimaging, and angiographic features of CNS-SS patients were correlated with the presence of precipitating anti-Ro(SS-A) autoantibodies detected by gel double-immunodiffusion or quantitative ELISA, which detects antibodies directed against the 60-kd peptide. Statistical analyses were performed using Fisher9s exact test (two-tailed) with Haldane9s adjustment and odds ratio with Cornfield 95% confidence intervals. Results: Precipitating antibodies against the Ro(SS-A) antigen, determined by gel double-immunodiffusion, were present in an increased frequency in CNS-SS patients with (1) documented clinical CNS disease, (2) focal clinical CNS manifestations and serious complications, (3) large regions of increased signal intensity, consistent with ischemia/infarcts on brain MRI scans or regions of decreased attenuation consistent with infarcts on CT, and (4) abnormal cerebral angiograms consistent with small-vessel angiitis. Finally, the anti-Ro(SS-A) antibody response in CNS was directed against the 60-kd peptide specificity, determined by ELISA. Conclusions: Clinical, neuroimaging (cerebral CT), and angiographic observation suggest that a subset of anti-Ro(SS-A) antibody-positive, in contrast with negative, CNS-SS patients have more serious and extensive CNS disease, some with frank cerebral angiopathy. Anti-Ro(SS-A) antibodies are postulated to play a role in mediating or potentiating vascular injury in CNS-SS. |
Databáze: | OpenAIRE |
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