Evaluation of clinical and laboratory findings of 147 patients with systemic lupus erythematosus: The relationship between anti-CCP and arthritis

Year 2019, , 227 - 230, 15.03.2019

Ali Ekin , Ayşe Ergüney Çefle

https://doi.org/10.28982/josam.503850

Abstract

Aim: Anti-cyclic citrullinated peptide antibodies (Anti-CCP) is considered as a novel marker in the assessment of rheumatoid disorders. Some studies have emphasized the importance of anti-CCP in indicating erosive arthropathy in Systemic Lupus Erythematosus (SLE), like Rheumatoid Arthritis (RA). These studies have reported that the chance of erosive arthritis development is significantly increased in anti-CCP-positive patients. This study aimed to investigate the relationship between anti-CCP and arthritis along with other clinical and laboratory parameters in patients with SLE.

Methods: A total of 147 SLE patients who had been admitted to Kocaeli University Medical Faculty, Department of Internal Medicine, Division of Rheumatology between January 2001 and October 2015 were included in this retrospective study. SLE diagnosis was verified according to American College of Rheumatology (ACR) and/or The Systemic Lupus Erythematosus International Collaborating Clinics (SLICC) criteria. Patients whose diagnosis was not definite and not having anti-CCP were excluded.

Results: Female/male ratio was found as 5.6, and the mean age was calculated as 43.9±11.85 years. The mean follow-up period was 73.3±44.97 months. Anti-CCP was found to be positive in ten patients whereas arthritis was found to be present in 100 patients. Anti-CCP was positive in seven patients with arthritis. RF (Rheumatoid Factor) was found as positive in 50 patients of whom 40 had arthritis. A relationship was found between Anti-CCP and RF. There was no relationship between anti-CCP and arthritis. 

Conclusions: Anti-CCP has been reported to be significantly related to arthritis and other characteristics of rheumatoid disorders, particularly RA in several studies. There are conflicting results about the relationship between anti-CCP and arthritis in patients with SLE. These conflicting results may be derived from different subtypes of anti-CCP (citrulline-dependent), different cut-off values, and characteristics of the patient population. We did not observe any relationship between the Anti-CCP and arthritis.

Keywords

Arthritis, Systemic lupus erythematosus, Anti-cyclic citrullinated peptide antibodies

Sistemik lupus eritematozuslu 147 hastanın klinik ve laboratuvar bulgularının değerlendirilmesi: Anti CCP ile artrit arasındaki ilişkinin incelenmesi

Abstract

Giriş: Anti-siklik sitrülline peptid antikorları (Anti-CCP), romatoid hastalıkların değerlendirilmesinde yeni bir belirteç olarak kabul edilir. Bazı çalışmalar Romatoid Artrit (RA) gibi sistemik lupus eritematozus’da (SLE) eroziv artropatinin gösterilmesinde Anti-CCP'nin önemini vurgulamıştır. Bu çalışmalar, Anti-CCP pozitif hastalarda eroziv artrit gelişme ihtimalinin anlamlı şekilde arttığını bildirmiştir. Bu çalışmanın amacı, SLE'li hastalarda Anti-CCP ve artrit ile diğer klinik ve laboratuvar parametreleri arasındaki ilişkiyi araştırmaktır. 

Yöntemler: Ocak 2001 - Ekim 2015 tarihleri arasında Kocaeli Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Romatoloji Bilim Dalı’na başvuran SLE'li toplam 147 hasta çalışmaya dahil edildi. SLE tanısı Amerikan Romatoloji Birliği (ACR) ve / veya Sistemik Lupus Eritematozus Uluslararası İşbirliği Klinikleri (SLICC) kriterleri ile doğrulandı. Kesin olmayan ve Anti-CCP si olmayan hastalar çalışma dışı bırakıldı. 

Bulgular: Kadın / erkek oranı 5,6, yaş ortalaması 43,9±11,85 idi. Ortalama takip süresi 73,3±44,97 aydı. 10 hastada anti-CCP pozitifti, 100 hastada ise artrit vardı. Artritli hastaların yedisinde Anti-CCP pozitifti. RF (Romatoid Faktör), 40’ı artritli olan 50 hastada pozitif bulundu. Anti-CCP ile RF arasında bir ilişki olduğu tespit edildi. Anti-CCP ile artrit arasında ise ilişki yoktu. 

Sonuçlar: Bazı çalışmalarda, özellikle RA gibi romatolojik hastalıkların artrit ve diğer özelliklerinin Anti-CCP ile bağlantısı olduğu rapor edilmiştir. SLE'li hastalarda anti-CCP ile artrit arasındaki ilişkiyle ilgili çelişkili sonuçlar vardır. Bu çelişkili sonuçlar farklı Anti-CCP alt tiplerden (sitrülin bağımlı), farklı cut-off değerlerinden ve hasta popülasyonunun özelliklerinden kaynaklanabilir. Anti-CCP ile artrit arasında herhangi bir ilişki gözlemlemedik.

Keywords

Sistemik lupus eritematozus, Anti-siklik sitrülline peptid antikorları, Artrit

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