RESEARCH - Anti-CCP and antikeratin antibodies in palindromic rheumatism. An abortive form of RA?

[Guest guest]

Rheumatology Advance Access published online on April 16, 2003

Rheumatology, doi:10.1093/rheumatology/keg268

Rheumatology © British Society for Rheumatology 2003; all rights reserved

© 2003 British Society for Rheumatology 2003; all rights reserved

Original Papers

Prevalence and clinical significance of anti-cyclic citrullinated peptide

and antikeratin antibodies in palindromic rheumatism. An abortive form of

rheumatoid arthritis?

G. Salvador 1*, A. Gomez 1, O. Viñas 2, G. Ercilla 2, J. D. Cañete 1, J.

Muñoz-Gomez 1, R. Sanmarti 1*

1 Hospital Clínic, Rheumatology

2 Hospital Clínic, Immunology, Barcelona, Barcelona, Spain

* Corresponding author. E-mail: sanmarti@... .

Received 7 August 2002 ; accepted 8 January 2003

Abstract

Objective. To analyse the prevalence and clinical significance of

anti-cyclic citrullinated peptide antibodies (anti-CCP) and antikeratin

antibodies (AKA) in patients with palindromic rheumatism (PR).

Method. Sixty-three patients with PR were included: 33 were defined as pure

or persistent PR at the time of serum test measurement, and 30 as associated

PR, defined as patients with past history of PR who had developed persistent

arthritis at the time of serum test: [21 with rheumatoid arthritis (RA)].

Sixty patients with early RA, and 80 with seronegative spondyloarthropathy

were included as control groups. Anti-CCP were determined by a standardized

ELISA test and AKA by indirect immunofluorescence in rat oesophagus.

Clinical characteristics of these pure PR patients were compared according

to the presence or absence of anti-CCP antibodies. A follow-up study was

also performed.

Results. Anti-CCP were detected in 18 out of 32 (56.3%) patients with pure

PR and 10 out of 30 (33.3%) with associated PR (38.1% in RA-associated PR

patients). AKA were detected in 12 patients out of 33, with pure PR (36.4%),

and in 9 out of 30 with associated PR (30%) (33.3% in RA-associated PR

patients). The prevalence of anti-CCP and AKA in the RA control group was

55% (not significantly different from the pure PR group) and 61.7% (with

respect to pure PR patients, P=0.02), respectively. In the

spondyloarthropathy group, the prevalence of anti-CCP and AKA was 2.5 and

3.8%, respectively (P<0.001 compared with pure PR patients). No significant

clinical differences were observed between pure PR patients with and without

CCP antibodies.

Conclusions. Anti-CCP and, to a lesser extent, AKA, were found in a high

proportion of patients with PR, suggesting that this syndrome is an abortive

form of RA. The predictive value of these antibodies in PR, as markers of

progression to an established RA, remains uncertain.

http://rheumatology.oupjournals.org/cgi/content/short/keg268v1

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org