Malemba J J, Mbuyi-Muamba J M, Mukaya J, Bossuyt X, Emonds M P, Deiteren K, Westhovens R, Verschueren P
Arthritis Res Ther. 2013 Aug 19;15(4):R89. doi: 10.1186/ar4269.
Little is known about rheumatoid arthritis in the black, particularly in Congolese, populations. Our objective was to describe the phenotype and genotype of rheumatoid arthritis (RA) in Congolese.
All consecutive rheumatoid arthritis (RA) patients attending Kinshasa University Hospital in a three-year time period were included. Demographics, clinical features and tobacco consumption were noted. Disease Activity Score (DAS)-28 based on the erythrocyte sedimentation rate (ESR), Health Assessment Questionnaire (HAQ), anti-citrullinated peptide antibodies (CCP) antibodies and rheumatoid factor (RF) were determined. Radiographs were scored according to Sharp-van der Heijde. On a subset of patients and controls HLA-DRB1 typing was performed.
A total of 114 females and 14 males aged 51.2 ± 14.9 were included. Mean duration of symptoms was four years. Moderate tobacco consumption was reported in a minority of patients. DAS-28 at first visit was >5.1 and HAQ ≥0.5 in all patients. X-rays showed joint erosions and/or joint space narrowing, mostly of a moderate grade in 55.8% of patients. Anti-CCP and/or RF were present in 48.6% of patients with available data (n = 72) and in 3.0% of controls (n = 67). Radiographic changes and nodules were more frequent in RF or anti-CCP positive patients. One copy of the shared epitope was found in 13 patients (35.1%) and 3 controls (12.5%). Two copies were found in one patient (2.7%) and in one control (4.2%).
Congolese patients with RA consult long after disease onset. Despite this delay, the majority presents without major damage and is RF, anti-CCP and SE negative. We put forward the hypothesis that besides different environmental factors there is probably also a particular genetic risk profile in Congolese patients, different from the HLA-DRB1 shared epitope.
关于黑人尤其是刚果人群中类风湿关节炎的情况，我们了解甚少。我们的目的是描述刚果人群中类风湿关节炎（RA）的表型和基因型。
纳入在三年时间内到金沙萨大学医院就诊的所有连续性类风湿关节炎（RA）患者。记录人口统计学信息、临床特征和烟草消费情况。根据红细胞沉降率（ESR）、健康评估问卷（HAQ）、抗瓜氨酸化肽抗体（CCP）和类风湿因子（RF）确定疾病活动评分（DAS）-28。根据Sharp-van der Heijde方法对X线片进行评分。对一部分患者和对照进行HLA-DRB1分型。
共纳入114名女性和14名男性，年龄为51.2±14.9岁。症状平均持续时间为4年。少数患者报告有中度烟草消费。所有患者首次就诊时DAS-28>5.1且HAQ≥0.5。X线显示关节侵蚀和/或关节间隙变窄，55.8%的患者大多为中度。在有可用数据的患者（n = 72）中，48.6%存在抗CCP和/或RF，在对照（n = 67）中为3.0%。RF或抗CCP阳性患者的影像学改变和结节更常见。13名患者（35.1%）和3名对照（12.5%）发现一份共享表位。一名患者（2.7%）和一名对照（4.2%）发现两份。
刚果RA患者在疾病发作后很长时间才就诊。尽管有此延迟，但大多数患者就诊时没有严重损害，且RF、抗CCP和SE均为阴性。我们提出假说，除了不同的环境因素外，刚果患者可能还存在一种特殊的遗传风险特征，不同于HLA-DRB1共享表位。
