Anti-cyclic citrullinated peptide antibodies in juvenile rheumatoid arthritis : prevalence & association with clinical, laboratory and radiographic findings

Abstract EN

Objective : to study the prevalence of anti-cyclic citrullinated peptide (anti-CCP) antibodies in patients with juvenile rheumatoid arthritis (JRA) and to evaluate the association of these antibodies with clinical manifestations, laboratory investigations and radiographic outcomes.

Patients and Methods : the study comprised 65 JRA patients (26 with polyarticular onset, 28 with pauciarticular onset and 11 with systemic onset).

All patients were subjected to complete history taking, thorough clinical examination, and laboratory investigations including determination of anti-CCP antibodies, rheumatoid factor (RF) and antinuclear antibodies (ANA).

Radiographs of hands and feet of all patients were also evaluated.

Results : Anti-CCP antibodies were found in 11 / 65 (16.9 %) of the patients.

The prevalence rates of these antibodies were 34.6 %, 7.1 % and 0.0 % in JRA patients with polyarticular onset, pauciarticular onset, and systemic onset respectively.

In JRA patients with polyarticular onset and RF-positive, the prevalence of anti-CCP antibodies was 70 %.

Presence of anti-CCP antibodies was found to be significantly associated with late disease onset, polyarticular onset, polyarticular course, RF positivity and radiographic joint damage.

Conclusion : the overall prevalence of anti-CCP antibodies in JRA is not high; however, these antibodies can be detected in a substantial proportion of JRA patients with polyarticular onset and RF-positive.

Anti-CCP antibodies in JRA are associated with late disease onset, polyarticular onset, polyarticular course and RF positivity.

In addition, presence of these antibodies in JRA patients is indicative for poorer radiological outcome, so cautious radiographic follow up is recommended for JRA patients having anti-CCP antibodies.