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EG |
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| Egypt J Pediatr Allergy Immunol |
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2014 |
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12 |
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71-76 |
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ESP - 170 |
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Original articles |
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| Expression and diagnostic utility of anti-cyclic citrullinated peptide
antibodies in juvenile idiopathic arthritis |
| Ashraf O. Sayed |
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Mohamed F. Afify |
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Abdu S. El Laban |
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| Background: Juvenile idiopathic arthritis (JIA) is a clinically
heterogeneous group of arthritis occurring in children. Anti-cyclic
citrullinated peptide (anti-CCP) antibodies have been recently included in
the revised diagnostic criteria for adult onset rheumatoid arthritis. Its
diagnostic value in JIA is still debatable. Objective: The study is aimed to
investigate the expression and diagnostic utility of anti-CCP antibodies in
pediatric JIA in relationship to its various clinical phenotypes. Methods:
Forty children and adolescents (13 males, 27 females) with JIA as well as 35
healthy children were enrolled in this cross-sectional study. Serum anti-CCP
antibodies were determined by enzymatic immunoassay and its expression
was statistically correlated to clinical, laboratory, and radiological data of
the patients. Results: Anti-CCP antibodies were positive in 8 (20%) patients
while not expressed in the control group. Seven out of the 8 positive cases
(87.5%) had polyarticular JIA and only one patient (12.5%) had the
oligoarticular onset variety. A significant positive correlation was elicited
between the anti-CCP antibody levels and the number of tender joints (r=
0.39), swollen joints (0.68) and disease duration (r = 0.59). Radiographic
erosive arthritis was found in 8 patients with positive anti-CCP antibodies; 7
of whom (87.5%) suffered the polyarticular subtype and only one patient
(12.5%) had the oligoarticular subtype. All the rheumatoid factor (RF)
seropositive patients had positive anti-CCP antibody as well as
radiographic erosive arthritis. The overall anti-CCP antibody diagnostic
value in our series showed a sensitivity and specificity of 20% and 100%
respectively and the positive and negative predictive values were 100%, and
52.2%, respectively. Conclusion: Anti-CCP antibodies have a low sensitivity
but high specificity in patients with JIA with a significant relationship to
clinical and radiologic severity especially in RF seropositive cases. It may
thus have a diagnostic and/or prognostic utility in severe polyarticular onset
disease. |
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