Anti-granulocyte scintigraphy in early rheumatoid arthritis — does it work?
To compare the performance of anti-granulocyte scintigraphy with those of widely used prognostic indices (such as DAS28, anti-CCP, early MRI imaging).
Twenty-five patients with early arthritis were enrolled into the study. Following the review of clinical data and the evaluation of disease activity, we performed MRI imaging of the hands, anti-granulocyte scintigraphy, and determined anti-CCP positivity. The relationship between the changes of MRI scores and the above prognostic factors were analyzed statistically.
At baseline, values were as follows: DAS28 3.86±1.19, CRI 0.15±0.12, MRI erosions and synovitis scores 25.11±12.82 and 4.32±4.02 (respectively), the ratio of anti-CCP positivity was 7/12 (58%). After the follow-up period of 13.6±2.52 months, erosion and synovitis scores were 43.11±22.23, and 5.32±6.16, respectively (p=0,001 and p=0,015). The occurrence of new erosions was correlated with baseline erosion score (k=0.523, p=0.022) and anti-CCP positivity (p=0.021). The relationship between CRI and baseline synovitis score was strong (=0.518, p=0.023), whereas it was weak only between the former and baseline erosion score (=0.402, p=0.08).
As shown by this study, potential markers for predicting subsequent destructiveness in early RA include MRI and anti-CCP testing, primarily. 99mTc labeled anti-granulocyte joint scintigraphy is appropriate for the objective and quantitative appraisal of disease activity.
KeywordsPrediction of erosiveness Leukocyte accumulation MRI Anti-granulocyte scintigraphy Anti-CCP positivity
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- Kellgren J.H., O’Brien W.M. On the natural history of rheumatoid arthritis in relation to the sheep cell agglutination test (SCAT), Arthritis. Rheum., 1962, 5, 115Google Scholar
- Sharp J.T., Calkins E., Cohen A.S., Schubart A.F., Calabro J.J. Observations on the clinical, chemical, and serological manifestations of rheumatoid arthritis, based on the course of 154 cases, Medicine (Baltimore), 1964, 43, 41–58Google Scholar
- Tseng S., Reddi A.H., Di Cesare P.E. Cartilage Oligomeric Matrix Protein (COMP): A Biomarker of Arthritis, Biomark. Insights. 2009, 17(4), 33–44Google Scholar
- Fujikawa K., Kawakami A., Tamai M., Uetani M., Takao S., Arima K., et al., High serum cartilage oligomeric matrix protein determines the subset of patients with early-stage rheumatoid arthritis with high serum C-reactive protein, matrix metalloproteinase-3, and MRI-proven bone erosion, J. Rheumatol., 2009, 36(6), 1126–1129PubMedCrossRefGoogle Scholar
- Syversen S.W., Goll G.L., van der Heijde D., Landewé R., Lie B.A., Odegard, S., et al., Prediction of radiographic progression in rheumatoid arthritis and the role of antibodies against mutated citrullinated vimentin: results from a ten-year prospective study, Ann. Rheum. Dis., 2010. 69(2), 345–351PubMedCrossRefGoogle Scholar
- Firestein G.S., Etiology and pathogenesis of rheumatoid arthritis, In: Kelly’s Texbook of Rherumatology (Harris E.D.Jr, Budd R.C., Genovese M.C., Firestein G.S., Sargent J.S., Sledge B.C. eds) 7th ed. Oxford 2004, 996–1042Google Scholar
- Hetland M.L., Ejbjerg B., Hørslev-Petersen K., Jacobsen S., Vestergaard A., Jurik A.G., et al. CIMESTRA study group., MRI bone oedema is the strongest predictor of subsequent radiographic progression in early rheumatoid arthritis. Results from a 2-year randomised controlled trial (CIMESTRA), Ann. Rheum. Dis., 2009, 68(3), 384–390PubMedCrossRefGoogle Scholar
- Ostendorf B., Schneider M., [Imaging beyond conventional radiography: mini arthroscopy, duplex ultrasonography and positron emission tomography] Z. Rheumatol., 2003, 62(Suppl 2), II 37–40Google Scholar
- Takalo R., Niemelä R., Karjalainen A., Leisti E.L., Kautiainen H., Hakala M., (99m)Technetium nanocolloid scintigraphy in prognostication of early RA Scand. J. Rheumatol. 2011, 40(2), 152–153Google Scholar