Kamalaksha Sujatha, White Douglas H N, Solanki Kamal K
Rheumatology Department, Waikato Hospital, Hamilton, New Zealand.
Waikato Clinical School, University of Auckland, Hamilton, New Zealand.
Int J Rheum Dis. 2018 Jul;21(7):1430-1435. doi: 10.1111/1756-185X.13330.
Systemic sclerosis (SSc) can present as an overlap syndrome with rheumatoid arthritis (SSc-RA overlap).
To evaluate the frequency of rheumatoid factor (RF) and anticyclic citrullinated peptide antibodies (anti-CCP) in our SSc cohort and their association with clinical features.
Data were gathered prospectively from the Waikato Hospital Systemic Sclerosis Clinics. Patients with SSc and SOS (systemic sclerosis overlap syndrome) underwent baseline auto-antibody profiling including RF and anti-CCP along with annual clinical review.
Our cohort comprised of 132 patients (two had incomplete data); 115 (87.1%) were female. Out of 89 limited cutaneous SSc (lcSSc) patients, arthralgia, synovitis, contractures, tendon crepitus and erosions on imaging were found in three, 10, 31, five and nine patients, respectively. Within the 33 diffuse cutaneous SSc (dcSSc) patients, arthralgia, synovitis, contractures, tendon crepitus and erosion were found in 15, five, 27, five and one patient, respectively. In the 10 SOS patients, arthralgia, synovitis and contractures were found in six, three and two patients; none had tendon crepitus or erosions. RF positivity was found in 15.7%, 9% and 20% of patients with lcSSc, dcSSc and SOS, and anti-CCP positivity was found in 13.5%, 6.1% and 0% in lcSSc, dcSSc and SOS patients. A statistically significant relationship of double antibody positivity with arthralgia (P = 0.03) and erosions (P < 0.001) was found. Anti-CCP positivity association with erosions was significant at P = 0.007.
Our study confirms that articular manifestations are common in SSc. Statistically significant associations of double antibody positivity with arthralgia and erosions were demonstrated. Significant association between anti-CCP antibody and erosions was also confirmed.
系统性硬化症（SSc）可表现为与类风湿关节炎的重叠综合征（SSc-RA重叠）。
评估我们的SSc队列中类风湿因子（RF）和抗环瓜氨酸肽抗体（抗CCP）的频率及其与临床特征的关联。
前瞻性收集怀卡托医院系统性硬化症诊所的数据。患有SSc和SOS（系统性硬化症重叠综合征）的患者接受了包括RF和抗CCP在内的基线自身抗体分析以及年度临床检查。
我们的队列包括132名患者（两名患者数据不完整）；115名（87.1%）为女性。在89例局限性皮肤型SSc（lcSSc）患者中，分别有3例、10例、31例、5例和9例出现关节痛、滑膜炎、挛缩、肌腱摩擦音和影像学上的侵蚀。在33例弥漫性皮肤型SSc（dcSSc）患者中，分别有15例、5例、27例、5例和1例出现关节痛、滑膜炎、挛缩、肌腱摩擦音和侵蚀。在10例SOS患者中，分别有6例、3例和2例出现关节痛、滑膜炎和挛缩；均无肌腱摩擦音或侵蚀。lcSSc、dcSSc和SOS患者中RF阳性率分别为15.7%、9%和20%，抗CCP阳性率在lcSSc、dcSSc和SOS患者中分别为13.5%、6.1%和0%。发现双抗体阳性与关节痛（P = 0.03）和侵蚀（P < 0.001）之间存在统计学显著关系。抗CCP阳性与侵蚀的关联在P = 0.007时具有显著性。
我们的研究证实关节表现在SSc中很常见。双抗体阳性与关节痛和侵蚀之间存在统计学显著关联。抗CCP抗体与侵蚀之间的显著关联也得到了证实。
