Detection of antisynthetase syndrome in patients with idiopathic interstitial pneumonias

作者：Watanabe Kizuku; Handa Tomohiro^*; Tanizawa Kiminobu; Hosono Yuji; Taguchi Yoshio; Noma Satoshi; Kobashi Yoichiro; Kubo Takeshi; Aihara Kensaku; Chin Kazuo; Nagai Sonoko; Mimori Tsuneyo; Mishima Michiaki

来源：Respiratory Medicine, 2011, 105(8): 1238-1247.

DOI：10.1016/j.rmed.2011.03.022

• Antisynthetase syndrome
• Aminoacyl-tRNA synthetase
• Idiopathic interstitial pneumonia
• Nonspecific interstitial pneumonia

Objectives: Antisynthetase syndrome (ASS) is characterized by autoantibodies to aminoacyl-tRNA synthetases (anti-synthetase) and it is frequently associated with interstitial lung disease. The purpose of this study was to elucidate the prevalence and characteristics of the anti-synthetase positive subpopulation among idiopathic interstitial pneumonias (IIPs) and to clarify the importance of screening for these antibodies.
Methods: A retrospective study was performed in 198 consecutive cases with IIPs. Screening for six anti-synthetase antibodies was performed in all cases. Clinical profiles of all cases were compared with reference to the presence of anti-synthetase. High-resolution computed tomography (HRCT) findings of anti-synthetase positive cases were also analyzed.
Results: 13 cases (6.6%) were positive for anti-synthetase. Anti-EJ was most prevalent, followed by anti-PL-12. Onset ages of anti-synthetase positive cases were younger than those of anti-synthetase negative cases. Extrapulmonary features of ASS were absent in 6 anti-synthetase positive cases (46.2%). Histologically, among 5 UIP with lymphoid follicles and 11 NSIP cases, the prevalence of anti-synthetase positive cases was 8/16 (50%). On HRCT, ground glass opacity and traction bronchiectasis were the major findings in anti-synthetase positive cases, while honeycombing was absent.
Conclusions: Anti-synthetase positive cases were not rare among IIPs. Anti-synthetase should be screened for in IIPs, especially in pathological NSIP or UIP with lymphoid follicles. These patients should be screened for anti-synthetase even if no suggestive extrapulmonary manifestation exists.

• 出版日期2011-8