J Rheumatol:50名ANCA阳性可卡因使用者的人口学、临床和免疫学相关性

2019-05-30 xiangting MedSci原创

研究确定了性别和种族是可卡因使用者出现CLAAS的重要风险调节因素。出现C-ANCA与死亡率升高相关。

可卡因/左旋咪唑-相关性自身免疫综合征(CLAAS)是一种知之甚少的药物诱发自身免疫的形式。这项研究的目标是更好地描述CLAAS的临床和免疫学特征谱,识别人口学风险因素,并形成关于发病机制的新假设。

确定2001年至2015年在华盛顿大学医学中心、Harborview医学中心和美国华盛顿州西雅图附属诊所就诊的CLAAS受试者。收集人口学、临床和免疫学指标并使用偶然和logistic回归进行相关性分析。使用类似的分析将CLAAS受试者与相关临床数据库中抗中性粒细胞胞浆抗体阳性(ANCA+)或使用可卡因(可卡因+)的个体进行比较。

确定了50名CLAAS受试者。与所有的可卡因+个体相比(n=2740),CLAAS受试者更多为女性,并且不太可能自我认定为黑人/非洲裔美国人。CLAAS受试者显示出几种ANCA类型,包括抗MPO(髓过氧化物酶)/抗PR3(蛋白酶3)双重反应性,该发现为CLAAS特异性。最常见的是血液、肾脏和皮肤异常,其中包括中性粒细胞减少和皮肤紫癜。最后,研究人员观察到胞浆ANCA(C-ANCA)类型与死亡率之间存在强烈的独立关联。

研究确定了性别和种族是可卡因使用者出现CLAAS的重要风险调节因素。出现C-ANCA与死亡率升高相关。此外,还证实了CLAAS中富含抗MPO/抗PR3双重反应性,进一步支持了该特征的诊断效用。

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    2019-06-01 Boyinsh
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