Prospective evaluation of the frequency and clinical significance of antineutrophil cytoplasmic and anticardiolipin antibodies in community cases of patients with rheumatoid arthritis
Identifieur interne : 002505 ( Main/Exploration ); précédent : 002504; suivant : 002506Prospective evaluation of the frequency and clinical significance of antineutrophil cytoplasmic and anticardiolipin antibodies in community cases of patients with rheumatoid arthritis
Auteurs : O. Vittecoq ; F. Jouen-Beades ; K. Krzanowska ; I. Bichon-Tauvel ; J. F. Menard [France] ; A. Daragon ; D. Gilbert ; F. Tron ; X. Le Loe TSource :
- Rheumatology [ 1462-0324 ] ; 2000.
Abstract
Objectives. To evaluate the frequencies of antineutrophil cytoplasmic (ANCA), anticardiolipin (aCLA) and anti‐β2‐glycoprotein 1 antibodies (aβ2‐GP1A) in rheumatoid arthritis (RA) of limited duration in patients recruited primarily from private practitioners (80%), and to attempt to correlate the presence of these antibodies with certain clinical and/or biological criteria. Patients and methods. Patients (n = 102) with RA evolving for <5 yr (mean 2.2 yr) were recruited. A home evaluation collected clinical data [Ritchie articular index, Health Assessment Questionnaire (HAQ) index, extra‐articular manifestations] and blood for biological analyses [C‐reactive protein (CRP), rheumatoid factor, ANCA, aCLA, aβ2‐GP1A]. ANCA were detected by indirect immunofluorescence on neutrophils and their specificity was determined by enzyme‐linked immunosorbent assay (ELISA) and confirmed by immunoblotting; aCLA and aβ2‐GP1A were detected by ELISA. Results. Patients had mild RA (Ritchie = 11/78 ± 9.6; HAQ = 0.79/3 ± 0.7), probably due to the recruitment procedure. ANCA, aCLA and aβ2‐GP1A frequencies were 18.5, 7 and 0%, respectively. Titres of ANCA and aCLA were low. A perinuclear ANCA staining pattern was exclusively observed and lactoferrin was shown to be the major antigen recognized. No relationship was found between ANCA and aCLA and/or rheumatoid factor, or any clinical manifestations. ANCA were more common in RA of longer duration (cut‐off: 4 yr; P = 0.05) and aCLA were correlated with the CRP level (P = 0.05). Conclusions. In RA of recent onset, ANCA and aCLA were detected at low titres and frequencies, and were not associated with any clinical manifestations. A longitudinal study is needed to determine whether their early appearance is predictive of subsequent disease severity.
Url:
DOI: 10.1093/rheumatology/39.5.481
Affiliations:
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<front><div type="abstract" xml:lang="en">Objectives. To evaluate the frequencies of antineutrophil cytoplasmic (ANCA), anticardiolipin (aCLA) and anti‐β2‐glycoprotein 1 antibodies (aβ2‐GP1A) in rheumatoid arthritis (RA) of limited duration in patients recruited primarily from private practitioners (80%), and to attempt to correlate the presence of these antibodies with certain clinical and/or biological criteria. Patients and methods. Patients (n = 102) with RA evolving for <5 yr (mean 2.2 yr) were recruited. A home evaluation collected clinical data [Ritchie articular index, Health Assessment Questionnaire (HAQ) index, extra‐articular manifestations] and blood for biological analyses [C‐reactive protein (CRP), rheumatoid factor, ANCA, aCLA, aβ2‐GP1A]. ANCA were detected by indirect immunofluorescence on neutrophils and their specificity was determined by enzyme‐linked immunosorbent assay (ELISA) and confirmed by immunoblotting; aCLA and aβ2‐GP1A were detected by ELISA. Results. Patients had mild RA (Ritchie = 11/78 ± 9.6; HAQ = 0.79/3 ± 0.7), probably due to the recruitment procedure. ANCA, aCLA and aβ2‐GP1A frequencies were 18.5, 7 and 0%, respectively. Titres of ANCA and aCLA were low. A perinuclear ANCA staining pattern was exclusively observed and lactoferrin was shown to be the major antigen recognized. No relationship was found between ANCA and aCLA and/or rheumatoid factor, or any clinical manifestations. ANCA were more common in RA of longer duration (cut‐off: 4 yr; P = 0.05) and aCLA were correlated with the CRP level (P = 0.05). Conclusions. In RA of recent onset, ANCA and aCLA were detected at low titres and frequencies, and were not associated with any clinical manifestations. A longitudinal study is needed to determine whether their early appearance is predictive of subsequent disease severity.</div>
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