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Evaluation of anti-cyclic citrullinated peptide antibodies may be beneficial in RF-negative juvenile idiopathic arthritis patients

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Abstract

Despite the high diagnostic and prognostic performance in adult rheumatoid arthritis, the role of antibodies to cyclic citrullinated peptide (anti-CCP) in juvenile idiopathic arthritis (JIA) is controversial. Occurrence of anti-CCP was mainly seen in rheumatoid factor (RF)-positive polyarthritis patients. In the present study, our aim was to investigate the prevalence and significance of anti-CCP for subjects with JIA in our population. We evaluated anti-CCP reactivity in the sera of 70 patients with various subtypes of JIA in a prospective cohort study. Anti-CCP titres were correlated with the evolution of joint involvement and the presence of joint damage. Nine JIA patients were seropositive for anti-CCP with respect to the cut-off value of the test. In our cohort, 34 patients had a polyarticular joint disease, most of them being RF-negative (30/34, 88 %). All four RF-positive polyarthritis patients had high anti-CCP concentrations and an aggressive erosive disease. In the RF-negative JIA patients, anti-CCP reactivity was in lower titres but significantly associated with polyarticular joint involvement (p = 0.016) and also with the presence of joint damage (p < 0.001). Presence of anti-CCP, at both low and high concentration, was significantly associated with a more severe articular disease in our JIA patients. Investigating anti-CCP should clearly be taken into consideration even among patients with JIA subtypes other than RF-positive polyarthritis.

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Abbreviations

CCP:

Cyclic citrullinated peptide

DMARDs:

Disease-modifying anti-rheumatic drugs

ERA:

Enthesitis-related arthritis

ILAR:

International League Against Rheumatism

IgG:

Immunoglobulin G

JIA:

Juvenile idiopathic arthritis

JADI-A:

Juvenile arthritis damage index-articular damage

JADAS-27:

Juvenile Arthritis Disease Activity Score-27

RA:

Rheumatoid arthritis

RF:

Rheumatoid factor

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Acknowledgments

This paper was published under the frame of European Social Found, Human Resources Development Operational Programme 2007–2013; project no. POSDRU 159/1.5/S/138776.

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Authors and Affiliations

  1. 2nd Department of Paediatrics, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania

    Mihaela Spârchez & Nicolae Miu

  2. 2nd Paediatric Clinic, Children’s Hospital at Cluj-Napoca, 3-5 Crisan Street, 400177, Cluj-Napoca, Romania

    Mihaela Spârchez & Claudia Bolba

  3. Department of Medical Informatics and Biostatistics, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania

    Mihaela Iancu

  4. 3rd Department of Internal Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania

    Zeno Spârchez

  5. Department of Rheumatology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania

    Simona Rednic

Authors
  1. Mihaela Spârchez
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  2. Nicolae Miu
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  3. Claudia Bolba
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  5. Zeno Spârchez
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Correspondence to Mihaela Spârchez.

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Spârchez, M., Miu, N., Bolba, C. et al. Evaluation of anti-cyclic citrullinated peptide antibodies may be beneficial in RF-negative juvenile idiopathic arthritis patients. Clin Rheumatol 35, 601–607 (2016). https://doi.org/10.1007/s10067-015-2971-5

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  • DOI: https://doi.org/10.1007/s10067-015-2971-5

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