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vol.46 issue3Diagnostic value of anti-cyclic citrullinated peptide antibody in rheumatoid arthritis author indexsubject indexarticles search
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Revista Brasileira de Reumatologia

Print version ISSN 0482-5004On-line version ISSN 1809-4570


SILVA, Aldifran Ferreira da et al. Association of anti-cyclic citrullinated peptide antibody and severe rheumatoid arthritis. Rev. Bras. Reumatol. [online]. 2006, vol.46, n.3, pp.165-173. ISSN 0482-5004.

OBJECTIVE: Evaluate the association of Anti-Cyclic Citrullinated Peptide Antibody (anti-CCP) with distinct clinic, serological and radiological parameters. METHODS: anti-CCP and rheumatoid factor (RF) were determined in the serum of 100 patients with rheumatoid arthritis (RA). Disease activity was defined by means of a combined index with five parameters: number of swollen joints, number of painful joints, morning stiffness, pain visual analogue scale (VAS), and erythrocyte sedimentation rate (ESR). Functional capacity was measured by (Health Assessment Questionnaire) HAQ index and the functional class was ascribed according to American College of Rheumatology criteria (1991). Articular erosion and narrowing were estimated by the modified Sharp's index. Statistical analysis was performed by chi-square, Mann-Whitney, and Kruskal-Wallis tests. A value of less 0.05 was considered significant. RESULTS: None of the two antibodies showed association with disease flare, gender, age in the time of diagnosis, secondary Sjögren's syndrome or subcutaneous nodules. The mean age was significantly lower in RA patients with positive anti-CCP. The RF and anti-CCP positivity was higher in RA patients below 50 years old than patients above 50 years old. The early RA, up to 2 years of evolution, was not associated with a higher prevalence of anti-CCP and RF reactivity. Anti-CCP showed direct moderate correlation to RF and also direct correlation to ESR and CRP. FR reactivity showed direct correlation to ESR and CRP. Functional class showed no association with neither autoantibodies. HAQ index showed correlation with anti-CCP-positive patients and activity assessed by ESR, but did not show association with disease activity, disease duration, presence of the RF and activity assessed by ESR. Sharp's erosion and narrowing index showed association to presence of anti-CCP, but not with RF positive patients. CONCLUSIONS: Although anti-CCP displays good diagnosis properties for RA, it appears not to be associated with activity disease, gender, age at the disease beginning, disease evolution, presence of the secondary Sjögren's syndrome and subcutaneous nodules or functional class. Anti-CCP reactivity showed association with early patients, RF positivity, ESR, CRP, HAQ index or Sharp'erosion and narrowing index.

Keywords : rheumatoid arthritis; autoantibodies; anti-CCP; rheumatoid factor; HAQ.

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