류마티스질환의검사의해석 - ekjm.org

1 :78 1 2010 -S29- .. ,,. ,, .. , . 1.( rheumatoid factor, RF) RF (1).. RFIgGFc portion ,RF . RF (2), .. RF. RF,, X.

2 RF . RF . 2. CCP RF Table ( rheumatoid factor) ()4.(6,,)5. 1**(1987 ):746. Table ~85%70~85%90~100%BC25~50%25~50%5~58%20~7 5%3~33%10~25%8%primary biliary cirrhosis45~70%5~25%(60)5~25% :78 1 2010-S30- .., (citrulline) 40. citrullinated protein filaggrin , .cyclic citrulline-substituted peptide (CCP)ELISACCP .80%,98% RF.

3 CCP . RF40% CCP2009 RF. (acute phase reactants) ,, .25% , albumin, transferrin, transthyretin . , ., (ESR)C- (CRP)., 3. 1. ,ESR CRP.

4 ESR, CRP . 2.(polymyalgia rheumatica, PMR)(giant cell arteritis, GCA) PMRGCAESR 40mm/hr80~90%. ESR .ESR CRPESR CRP. (Antinuclear Antibodies, ANA) ANA HEp-2 . ANA..ANA25~30% ,. ANA4. Table 3. ESR CRPESRCRP(mm/hr) :=/2=(+10)/2,, .-S31- ANA . homogenous, peripheral, specklednucleolar 4.

5 (5).HLA B27 HLA B27 .HLAB27, ,. HLA B ( 6~10%). HLA B 27 .(, )HLAB27 40 .REFERENCES1)American College of Rheumatology Ad Hoc Committee onImmunologic Testing Guidelines. Guidelines for immunologiclaboratory testing in the rheumatic disease: an Rheum 2002;47; ) Kavanaugh A, Tomar R, Reveille J, Solomon DH, for clinical use of the antinuclear antibodytest and tests for specific autoantibodies to nuclear pathol Lab Med 2000;124; ).

6 1 . 2006. ) Theodore pincus, Yusuf Yazici, Tuulikki Assessment of rheumatoid arthritis : Absence of a SingleGold Standard Measure. Rheum Dis Cli N Am 2009;35; ) Theodore pincus, Yusuf Yazici, Martin PatientQuestionnaires in rheumatoid arthritis : Advantages andLimitations as a Quantitative, Standardized Scientific MedicalHistory. Rheum Dis Cli N Am 2009;35; ) Solomon DH, Kavanaugh AF, Schur AmericanCollege of Rheumatology Ad Hoc Committee on ImmunologicTesting Guidelines. Evidence-based guidelines for the use ofimmunologic test: antinuclear antibody testing. ArthritisRheum 2002;47; ) Kavanaugh AF, Solomon American College ofRheumatology Ad Hoc Committee on Immunologic TestingGuidelines. Guidelines for immunologic laboratory testing inthe rheumatic disease: anti-DNA antibody tests.

7 arthritis Rheum2002;47; ) SwaakT, of anti-dsDNA as a diagnostictool: a prospective study in 441 non-systemic lupuserythematosus patients with anti-dsDNA antibody. Ann RheumDis 1985;44; ) Benito-Garcia E, Schur PH, Lahita American Collegeof Rheumatology Ad Hoc Committee on Immunologic TestingGuidelines. Guidelines for immunologic laboratory testingin the rheumatic diseases: anti-Sm and anti-RNP antibody Rheum 2004;51; ) Hochberg M, Silman AJ, Smolen JS, Weinblatt ME, 3rd ed. Mosby, ) Dorner T, Egerer K, Feist E, Burmester revisited. Curr Opin Rhematol 2004;16;246-53. Table 4. (%)95~10060~8010040~705261primary autoimmune cholangitis4650100100 Table 5. Homogeneous- dsDNA (deoxyribonucleoprotein)-histone,Periphe ral or rim-dsDNA, laminsSpeckled-Sm-Ro/SSALa/SSB- CentromereNucleolar-Scl-70- RNA polymerase I :78 1 2010-S32-12) Soubrier M, Dougados to assess early rheumatoidarthritis in daily clinical practice.

8 Best pract Res Clin Rheumatol2005;19; ) van Boekel MA, Vossenaar ER, van den Hoogen FH, vanBenrooij systems in rheumatoid arthritis :specificity, sensivitiy and diagnositc value. arthritis Res2002;4; ) Zendman AJ, Vossenaar ER, van Benrooij citrullinated(poly)peptides: a key diagnostic and prognosticmarker for rheumatoid arthritis . Autoimmunity 2004;37; ) van Benrooij WJ, Vossenaar ER, Zendman : the new rheumatoid factor in the serology ofrheumatoid arthritis . Autoimmun Rev 2004;3; ) Schellekens GA, Visser H, de Jong den HoogenFH, Hazes JM, Breedveld FC, et al. The diagnostic propertiesof rheumatoid arthritis antibodies recognizing a cycliccitrullinated peptide. arthritis Rheum 2000;43;155-63.