抗Th/To抗体阳性间质性肺炎急性加重报道1例并文献复习  

A case report of acute exacerbation of interstitial pneumonia with anti Th/To antibody positive and literature review

作　　者：郭申浩 何海浪[1] 周贤梅[1] Guo Shenhao;He Hailang;Zhou Xianmei(Affiliated hospital of Nanjing University of Traditional Chinese Medicine,Nanjing,Jiangsu,210009,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210009

出　　处：《齐齐哈尔医学院学报》2024年第3期242-245,共4页Journal of Qiqihar Medical University

摘　　要：目的分享1例抗Th/To抗体阳性间质性肺炎急性加重的临床表现及诊治经过,了解抗Th/To抗体的临床意义,为临床诊疗提供参考。方法收集1例抗Th/To抗体阳性间质性肺炎急性加重患者的临床资料,包括患者的性别、年龄等一般信息以及临床表现、实验室检查和影像学特点;结合文献复习,对临床资料进行分析。结果患者女,75岁,因“胸闷气喘7 d”于2023年7月31日收治入院。胸部HRCT显示间质性肺炎,ANA 1︰320,ENA(-),抗中性粒细胞抗体PANCA(甲醛敏感)(+),唇腺活检病理(-),肌炎抗体谱提示Th/To抗体阳性,查体面部、上肢皮肤色深,技工手,无明显皮肤硬化表现,四肢肌力正常,考虑结缔组织疾病相关间质性肺炎急性加重。予糖皮质激素联合环磷酰胺治疗后逐渐好转出院。结论抗Th/To抗体是一种核仁抗体,阳性患者常见于局限性硬皮病,内脏受累较轻,但常伴有间质性肺炎和肺动脉高压。对于间质性肺炎患者可积极完善肌炎抗体谱检查,在充分评估患者病情后慎重选择支气管镜检查。Objective To share the clinical manifestations,diagnosis and treatment of acute exacerbation of interstitial pneumonia with positive anti-Th/To antibody,to understand the clinical significance of anti-Th/To antibody,and to provide reference for clinical diagnosis and treatment.Methods Clinical data of a patient with acute exacerbation of interstitial pneumonia with positive anti-Th/To antibody was collected,including gender,age and other general information as well as clinical manifestations,laboratory examination and imaging features.Combined with literature review,clinical data were analyzed.Results A 75-year-old female patient was admitted to hospital on July 31,2023 due to chest tightness and asthma for 7 days.The chest HRCT showed interstitial pneumonia,ANA 1:330,ENA(-),anti-neutrophil antibody PANCA(formaldehyde sensitive)(+),labial gland biopsy pathology(-),myositis antibody spectrum indicated Th/To antibody positive,the skin of the face and upper limbs was dark during physical examination,dermatomyositis,showed no obvious manifestations of skin sclerosis,and the muscle strength of the limbs was normal.Consider an acute exacerbation of interstitial pneumonia associated with connective tissue disease.She was treated with glucocorticoid combined with cyclophosphamide and the situation gradually get better and finally discharged.Conclusions Anti-Th/To antibody is a kind of nucleolar antibody,and positive patients are often suffer from localized scleroderma,with mild visceral involvement,but often accompanied by interstitial pneumonia and pulmonary hypertension.For patients with interstitial pneumonia,myositis antibody spectrum examination can be conducted actively,and bronchoscopy should be carefully selected after fully evaluating the patient's condition.

关 键 词：间质性肺炎 急性加重 抗Th/To抗体 

分 类 号：R563.1[医药卫生—呼吸系统]