| Background: JRA is currently diagnosed using the American College of
Rheumatology (ACR) 1987 revised criteria that are primarily based on clinical
parameters. The criteria may be insufficient for the diagnosis of early RA as
they are based upon measurements of disease classification predominately
featuring manifestations typical of later-stage disease. Measurement of serum
anti-mutated citrullinated vimentin antibodies (MCV) has been shown to be a
better marker for early adult RA, and it correlates well with the disease activity
score (DAS). Objectives: The aim of this work is to evaluate the role of antimutated
citrullinated vimentin antibodies (anti-MCV) in the diagnosis, and in
monitoring disease activity in juvenile rheumatoid arthritis. Methods: The study
included 40 children with JRA fulfilling the American College of Rheumatology
criteria for diagnosis of JRA: 4 children with oligoarticular JRA, 12 with
polyarticular JRA and 24 children with systemic onset JRA. Fifty healthy
children, matching the patients in age and sex served as a control group. The
studied children with JRA were subjected to laboratory tests including CBC,
ESR, CRP, ANA and rheumatoid factor (RF). Serum samples from both patients
and controls were assayed for anti-MCV levels using an ELISA technique.
Results: The study showed high mean serum anti-MCV antibodies level in JRA
patients when compared to controls (P= 0.00). In addition, there were no
significant correlations between anti-MCV antibody levels and parameters of
disease activity, namely, number of swollen joints, number of tender joints, ESR
and CRP. The receiver operating characteristic (ROC) curve was drawn and it
showed that the area under the curve (AUC) was (0.896). At a cutoff level > 17
u/mL, anti-MCV antibodies had diagnostic specificity of 88%, diagnostic
sensitivity of 87.5%, negative and positive predictive values of 89.8% and
85.4%, respectively and diagnostic efficacy of 87.8%. We also reported 3/40 of
JRA patients to be positive for RF and 2/40 of JRA patients to be positive for
ANA. Conclusion: Measurement of serum anti MCV antibody level holds
promise as a diagnostic tool in JRA. However, they failed to show a significant
efficacy in determining disease activity. |