Ferreira Rosa A, Silva Carlos H M, Silva Deise A O, Sopelete Monica C, Kiss Maria H B, Mineo Jose R, Ferriani Virginia P L
Department of Pediatrics, School of Medicine of Ribeirão Preto, University of São Paulo, Av. Bandeirantes, 3900, CEP: 14049-900, Ribeirao Preto, SP, Brazil.
Rheumatol Int. 2007 Feb;27(4):345-9. doi: 10.1007/s00296-006-0221-5. Epub 2006 Sep 29.
The prevalence and clinical relevance of IgM and IgA RF detected by ELISA were studied in 91 patients with juvenile rheumatoid arthritis (JRA) and 45 healthy children. IgM and IgA RF were detected, respectively, in 33 and 44% of the patients, compared to 6.7 and 15.6% of the healthy children (p = 0.001 and 0.0006, respectively). The frequency of IgM RF was significantly higher in patients with polyarticular (52%) as compared to systemic onset JRA (21%; p = 0.04). Five out of ninety-one patients and none of the control group were IgM RF positive by the latex test. High levels of IgM RF were detected more frequently in patients with active disease (p = 0.01) and positive latex agglutination test (p < 0.001) and had a marginally significant association with severe radiological deformities (p = 0.05). The presence of IgA RF was associated with active disease in polyarticular onset JRA children (p = 0.04). In conclusion, high levels of IgM RF and the detection of IgA RF can be useful in assessing clinical activity in a subset of patients with JRA.
通过酶联免疫吸附测定法（ELISA）检测的IgM和IgA类风湿因子（RF）的患病率及临床相关性，在91例幼年类风湿关节炎（JRA）患者和45名健康儿童中进行了研究。患者中分别有33%和44%检测到IgM和IgA RF，相比之下，健康儿童中这一比例分别为6.7%和15.6%（p值分别为0.001和0.0006）。多关节型JRA患者中IgM RF的频率（52%）显著高于全身型JRA患者（21%；p = 0.04）。91例患者中有5例IgM RF通过乳胶试验呈阳性，而对照组无一例阳性。在疾病活动期患者（p = 0.01）和乳胶凝集试验呈阳性的患者中（p < 0.001），更频繁地检测到高水平的IgM RF，且与严重的放射学畸形有边缘性显著关联（p = 0.05）。IgA RF的存在与多关节型起病的JRA儿童的疾病活动相关（p = 0.04）。总之，高水平的IgM RF和IgA RF的检测有助于评估一部分JRA患者的临床活动情况。
