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Diagnostic utility of anti-cyclic citrullinated peptide antibodies for rheumatoid arthritis in patients with active lung tuberculosis

Clinical Rheumatology volume 28, pages 277–283 (2009)Cite this article

Abstract

This study was intended to evaluate the utility of anti-cyclic citrullinated peptide antibodies (second generation, anti-CCP2) as a diagnostic marker for rheumatoid arthritis (RA) in patients with active tuberculosis. Among 89 patients with active tuberculosis, anti-CCP2 was detected in six (6.7%), and three of these (3.4%) were strongly positive for anti-CCP2. The positive rate of anti-CCP2 in patients with newly diagnosed RA was 82.1% (87 of 106 cases), while the rate in healthy control subjects was 0.4% (one of 237 individuals). The mean level of anti-CCP2 among the RA group was 159.3 U/ml, which was significantly higher than both that among the tuberculosis group (15.4 U/ml) and that among the healthy controls (0.7 U/ml). IgM rheumatoid factor (RF) was detected in 16 patients from the tuberculosis group (18.0%) with a mean serum level of 18.6 IU/ml and in 77 patients of the RA group (72.6%) with a mean level of 164.0 IU/ml. Only two cases in the tuberculosis group were positive for both anti-CCP2 and IgM RF. These observations show that measurement of anti-CCP2 seems to be a reliable serological tool for identifying early RA in patients with active tuberculosis.

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Affiliations

  1. Clinical Research Center for Rheumatic Disease and Department of Rheumatology, Kumamoto Saishunsou National Hospital, 2659 Suya, Kohshi, Kumamoto, 861-1196, Japan

    Shunsuke Mori

  2. Department of Medicine, Kumamoto Kohnan Hospital, Kumamoto, Japan

    Hiromichi Naito

  3. Department of Medicine, Minami Yokohama National Hospital, Yokohama, Japan

    Sumire Ohtani

  4. Department of Medicine, Kumamoto Minami National Hospital, Kumamoto, Japan

    Tohru Yamanaka

  5. Division of Respiratory Medicine, Department of Medicine, Kumamoto Saishunsou National Hospital, Kumamoto, Japan

    Mineharu Sugimoto

Authors
  1. Shunsuke Mori
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  2. Hiromichi Naito
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  3. Sumire Ohtani
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  4. Tohru Yamanaka
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  5. Mineharu Sugimoto
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Correspondence to Shunsuke Mori.

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Mori, S., Naito, H., Ohtani, S. et al. Diagnostic utility of anti-cyclic citrullinated peptide antibodies for rheumatoid arthritis in patients with active lung tuberculosis. Clin Rheumatol 28, 277–283 (2009). https://doi.org/10.1007/s10067-008-1035-5

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  • DOI: https://doi.org/10.1007/s10067-008-1035-5

Keywords

  • Anti-cyclic citrullinated peptide antibodies
  • Rheumatoid arthritis
  • Rheumatoid factor
  • Tuberculosis