Aigner E, Schmid I, Osterreicher C H, Zwerina J, Schett G, Strasser M, Niksic F, Hohla F, Ramsauer T, Dorn U, Patsch W, Datz C
Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of Paracelsus Medical University Salzburg, Oberndorf, Austria.
Ann Rheum Dis. 2007 Sep;66(9):1249-51. doi: 10.1136/ard.2007.071621. Epub 2007 Apr 24.
To investigate the prevalence of antibodies to cyclic citrullinated peptide (anti-CCP) and rheumatoid factor in patients with hereditary haemochromatosis (HHC) and to evaluate their diagnostic reliability in distinguishing HHC-associated arthropathy from rheumatoid arthritis.
Anti-CCP antibodies and rheumatoid factor levels were determined by ELISA in sera from 87 patients with HHC homozygous for the C282Y mutation of the HFE gene, 31 patients with rheumatoid arthritis and 162 healthy controls.
Of the 87 patients with HHC, 32 (36.8%) had joint involvement. Anti-CCP antibodies were detected in only 1 patient (1.1%) with HHC, who had no joint disease, and in (1.2%) healthy controls. In total, 18 (58.1%) patients with rheumatoid arthritis displayed anti-CCP reactivity (p<0.001). Rheumatoid factor was detected in 10 (11.5%) patients with HHC compared with 7 (4.3%) healthy control subjects (p = 0.03) and 21 of 31 (65.6%) patients with rheumatoid arthritis.
Testing for anti-CCP antibodies discriminates HHC arthropathy from rheumatoid arthritis, as these patients were consistently anti-CCP negative. Thus, HHC arthropathy should be considered in the differential diagnosis of CCP-negative arthritis.
研究遗传性血色素沉着症（HHC）患者中抗环瓜氨酸肽抗体（抗CCP）和类风湿因子的患病率，并评估它们在区分HHC相关关节病与类风湿关节炎方面的诊断可靠性。
采用酶联免疫吸附测定法（ELISA）检测87例HFE基因C282Y突变纯合子的HHC患者、31例类风湿关节炎患者和162例健康对照者血清中的抗CCP抗体和类风湿因子水平。
87例HHC患者中，32例（36.8%）有关节受累。仅1例（1.1%）无关节疾病的HHC患者及1.2%的健康对照者检测到抗CCP抗体。总计18例（58.1%）类风湿关节炎患者表现出抗CCP反应性（p<0.001）。10例（11.5%）HHC患者检测到类风湿因子，相比之下，7例（4.3%）健康对照者检测到类风湿因子（p = 0.03），31例类风湿关节炎患者中有21例（65.6%）检测到类风湿因子。
检测抗CCP抗体可区分HHC关节病与类风湿关节炎，因为这些患者抗CCP抗体始终为阴性。因此，在CCP阴性关节炎的鉴别诊断中应考虑HHC关节病。
