Mori Shunsuke, Naito Hiromichi, Ohtani Sumire, Yamanaka Tohru, Sugimoto Mineharu
Clinical Research Center for Rheumatic Disease and Department of Rheumatology, Kumamoto Saishunsou National Hospital, 2659 Suya, Kohshi, Kumamoto 861-1196, Japan.
Clin Rheumatol. 2009 Mar;28(3):277-83. doi: 10.1007/s10067-008-1035-5. Epub 2008 Nov 11.
This study was intended to evaluate the utility of anti-cyclic citrullinated peptide antibodies (second generation, anti-CCP2) as a diagnostic marker for rheumatoid arthritis (RA) in patients with active tuberculosis. Among 89 patients with active tuberculosis, anti-CCP2 was detected in six (6.7%), and three of these (3.4%) were strongly positive for anti-CCP2. The positive rate of anti-CCP2 in patients with newly diagnosed RA was 82.1% (87 of 106 cases), while the rate in healthy control subjects was 0.4% (one of 237 individuals). The mean level of anti-CCP2 among the RA group was 159.3 U/ml, which was significantly higher than both that among the tuberculosis group (15.4 U/ml) and that among the healthy controls (0.7 U/ml). IgM rheumatoid factor (RF) was detected in 16 patients from the tuberculosis group (18.0%) with a mean serum level of 18.6 IU/ml and in 77 patients of the RA group (72.6%) with a mean level of 164.0 IU/ml. Only two cases in the tuberculosis group were positive for both anti-CCP2 and IgM RF. These observations show that measurement of anti-CCP2 seems to be a reliable serological tool for identifying early RA in patients with active tuberculosis.
本研究旨在评估抗环瓜氨酸肽抗体（第二代，抗CCP2）作为活动性结核病患者类风湿关节炎（RA）诊断标志物的效用。在89例活动性结核病患者中，6例（6.7%）检测到抗CCP2，其中3例（3.4%）抗CCP2呈强阳性。新诊断RA患者中抗CCP2的阳性率为82.1%（106例中的87例），而健康对照者中的阳性率为0.4%（237人中的1人）。RA组抗CCP2的平均水平为159.3 U/ml，显著高于结核病组（15.4 U/ml）和健康对照组（0.7 U/ml）。在结核病组的16例患者（18.0%）中检测到IgM类风湿因子（RF），血清平均水平为18.6 IU/ml，在RA组的77例患者（72.6%）中检测到RF，平均水平为164.0 IU/ml。结核病组中只有2例抗CCP2和IgM RF均为阳性。这些观察结果表明，检测抗CCP2似乎是识别活动性结核病患者早期RA的可靠血清学工具。
