Department of Biotechnology, Yonsei University College of Life Science and Biotechnology, Seoul, Republic of Korea.
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Clin Rheumatol. 2018 Oct;37(10):2771-2779. doi: 10.1007/s10067-017-3902-4. Epub 2017 Nov 8.
We investigated the rate of rheumatoid factor (RF) false positivity at diagnosis and its influence on clinical and prognostic features and rheumatoid arthritis (RA) development during the follow-up in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients without RA or other medical conditions triggering RF false positivity. We reviewed the medical records of 128 AAV patients. We divided patients with AAV and each variant into two groups according to RF positivity and compared variables between the two groups. Odds ratio and cumulative relapse-free survival rate were obtained by multivariate logistic regression analysis and the Kaplan-Meier survival analysis, respectively. The mean age at diagnosis was 53.6 years and 41 patients were male. Of 128 AAV patients, 69 patients (53.9%) were classified as microscopic polyangiitis (MPA), 29 (22.7%) as granulomatosis with polyangiitis (GPA) and 30 (23.4%) as eosinophilic GPA (EGPA). The rate of RF false positivity was 39.1% in AAV patients. On univariate analysis, general, cutaneous and mucous and ocular manifestations and myeloperoxidase (MPO)-ANCA (or perinuclear (P)-ANCA) positivity were associated with RF false positivity in patients with AAV. On multivariate analysis, cutaneous manifestation was the only independent predictor of RF false positivity in EGPA patients. RF false positivity had no influence on cumulative relapse-free survival rate of AAV or RA development during the follow-up. RF false positivity rate was 39.1% in AAV patients and it was associated with cutaneous manifestation in EGPA patients at diagnosis, but not relapses of AAV or RA development during the follow-up.
我们研究了在无类风湿关节炎（RA）或其他可导致类风湿因子（RF）假阳性的医学病症的抗中性粒细胞胞浆抗体（ANCA）相关性血管炎（AAV）患者中，诊断时 RF 假阳性的发生率及其对临床和预后特征以及随访期间 RA 发展的影响。我们回顾了 128 例 AAV 患者的病历。我们根据 RF 阳性将 AAV 患者及其各亚型分为两组，并比较了两组间的变量。通过多变量逻辑回归分析获得比值比，通过 Kaplan-Meier 生存分析获得累积无复发生存率。诊断时的平均年龄为 53.6 岁，41 例为男性。128 例 AAV 患者中，69 例（53.9%）为显微镜下多血管炎（MPA），29 例（22.7%）为肉芽肿性多血管炎（GPA），30 例（23.4%）为嗜酸性粒细胞性 GPA（EGPA）。AAV 患者中 RF 假阳性率为 39.1%。单因素分析显示，一般、皮肤、黏膜和眼部表现以及髓过氧化物酶（MPO）-ANCA（或核周（P）-ANCA）阳性与 AAV 患者的 RF 假阳性相关。多因素分析显示，皮肤表现是 EGPA 患者 RF 假阳性的唯一独立预测因子。RF 假阳性对 AAV 或随访期间 RA 发展的累积无复发生存率无影响。AAV 患者 RF 假阳性率为 39.1%，与 EGPA 患者诊断时的皮肤表现相关，但与 AAV 复发或随访期间 RA 发展无关。
