Yamazaki Hiromitsu, Kuroiwa Takanori, Shinmura Ken, Yukioka Masao, Murata Norikazu
Division of General Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Department Rheumatology, Yukioka Hospital, Osaka, Japan.
Mod Rheumatol. 2021 Mar;31(2):458-461. doi: 10.1080/14397595.2020.1761070. Epub 2020 May 19.
Anti-cyclic citrullinated peptide (CCP) antibodies are frequently detected in the sera of patients with rheumatoid arthritis (RA). However, recent studies have revealed a potentially high prevalence rate of these antibodies in patients with other rheumatic disorders, causing confusion while diagnosing RA. Therefore, this study aimed to evaluate the positive rate of anti-CCP antibodies in other chronic arthritis diseases focusing on patients with spondyloarthritis (SpA).
A total of 109 patients who were diagnosed with SpA at Yukioka Hospital from 1993 to 2018 were included in this retrospective analysis, including patients with ankylosing spondylitis (AS); psoriatic arthritis (PsA); synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome (SAPHO); undifferentiated spondyloarthritis (uSpA); reactive arthritis (ReA); and inflammatory bowel disease-associated SpA (IBD).
Overall, 15.3% (16/109) of patients with SpA were positive for anti-CCP antibodies, including 2.3% (1/43) in AS, 23.1% (3/13) in SAPHO, 35.0% (7/20) in PsA, 14.8% (4/27) in uSpA, 0% (0/3) in ReA, and 33.3% (1/3) in IBD.
PsA patients have a significantly higher prevalence rate of positive anti-CCP antibodies among SpA patients, and the positive rates in SAPHO and uSpA were also high. These findings provide insight into the heterogeneity of SpA with relevance for RA differential diagnosis.
抗环瓜氨酸肽(CCP)抗体在类风湿关节炎(RA)患者血清中常被检测到。然而,最近的研究表明,这些抗体在其他风湿性疾病患者中的患病率可能较高,这在诊断RA时会造成混淆。因此,本研究旨在评估以脊柱关节炎(SpA)患者为重点的其他慢性关节炎疾病中抗CCP抗体的阳性率。
本回顾性分析纳入了1993年至2018年在雪冈医院被诊断为SpA的109例患者,包括强直性脊柱炎(AS)患者;银屑病关节炎(PsA)患者;滑膜炎、痤疮、脓疱病、骨肥厚和骨炎综合征(SAPHO)患者;未分化脊柱关节炎(uSpA)患者;反应性关节炎(ReA)患者;以及炎症性肠病相关SpA(IBD)患者。
总体而言,15.3%(16/109)的SpA患者抗CCP抗体呈阳性,其中AS患者为2.3%(1/43),SAPHO患者为23.1%(3/13),PsA患者为35.0%(7/20),uSpA患者为14.8%(4/27),ReA患者为0%(0/3),IBD患者为33.3%(1/3)。
在SpA患者中,PsA患者抗CCP抗体阳性率显著更高,SAPHO和uSpA患者中的阳性率也较高。这些发现为SpA的异质性提供了见解,对RA的鉴别诊断具有重要意义。