Psöriyatik Artritli Hastalarda Anti-Siklik Sitrülinli Peptit Pozitifliği ile Klinik/Radyolojik Bulgular Arasındaki İlişki

Abstract

Psöriatik artrit (PsA), psöriazis öyküsü olan spondiloartropati grubundaki kronik inflamatuar bir hastalıktır. Bazı PsA bulguları romatoid artrit (RA) ile benzer olmasına rağmen, romatoid faktör negatifliği ile bazı radyolojik ve klinik bulgular PsA'da farklıdır. PsA tanısı için özel bir laboratuvar testi yoktur. Öte yandan anti-siklik sitrüline peptit (anti-CCP) antikor pozitifliği RA tanısı için spesifiktir. Amaç: Bu çalışmada PsA'da anti-CCP pozitifliğinin sıklığını, klinik ve radyolojik bulgularla ilişkisini incelemeyi amaçladık. Yöntemler: Çalışma grubu, PsA için CASPAR kriterlerini karşılayan 100 PsA hastası ve 100 sağlıklı kontrolden (SK) oluşmaktadır. Tüm hastalar için, klinik ve laboratuvar bulgularını içeren bir form doldurulduk ve hastaların serumlarında anti-CCP antikorunu mikro-ELISA yöntemi ile analiz ettik. Bulgular: Çalışmamızda PsA grubunun %15'inde ve sağlıklı kontrollerin %4'ünde anti-CCP pozitifliği saptandı. Fark istatistiksel olarak anlamlıydı (p=0.014; OR=4.24, %95 GA=1.35-13.25). 15 anti-CCP pozitif hastanın dokuzu kadın, geri kalan 6'sı erkekti. On üç hastada (%86,7) periferik artrit, 1 hastada (%6,7) sakroiliit, 1 hastada (%6,7) periferik artrit ve sakroiliit vardı. Periferik artritli PsA hastalarının %42,8'inde asimetrik oligoartrit (6/14), %28,5'inde monoartrit (4/14) ve %28,5'inde simetrik poliartrit (4/14) vardı. Anti-CCP antikor pozitifliğinin periferik artrit tutulumu üzerine etkisi yoktu. Anti-CCP negatif grupta sakroiliit ve daktilit daha sıktı. Daktilitli hiçbir hastada anti-CCP pozitifliği yoktu (p=0,005). RF pozitif hastaların %43,5'inde anti-CCP pozitifliği saptanırken, RF negatif hastaların %6,5'inde anti-CCP pozitifliği saptandı (p=0,000). Sonuç: Verilerimiz, SK'e kıyasla PsA'da anti-CCP pozitifliğinin daha sık olduğunu ortaya koymaktadır. Ancak Anti-CCP pozitifliği ile klinik veya radyolojik bulgular arasında istatistiksel bir ilişki bulunmamıştır.

Keywords

• PSÖRİYATİK ARTRİT
• ANTİ-SİKLİK SİTRÜLİNLİ PEPTİT
• ROMATOİD FAKTÖR

The Relationship between Anti-Cyclic Citrullinated Peptide Positivity and Clinical/Radiological Findings in Patients with Psoriatic Arthritis

Abstract

Psoriatic arthritis (PsA) is a chronic inflammatory disease in the spondyloarthropathy group with the history of psoriasis. Although some PsA findings are similar to rheumatoid arthritis (RA), rheumatoid factor negativity, some radiological and clinical findings are different in PsA. There is no spesific laboratory examination for diagnosis of PsA. On the other hand, anti-cyclic citrullinated peptide (anti-CCP) antibody positivity is a spesific finding for the diagnosis of RA. Objectives: We aimed in this study to analyse the frequency of anti-CCP positivity in PsA and the association with clinical and radiological findings. Methods: The study group is consisted of 100 PsA patients, who fulfilled the CASPAR cirteria for PsA and 100 healthy controls (HC). We filled a form for all patients, which included clinical and laboratory findings of patients. We analyzed anti-CCP antibody with micro-ELISA in the sera of patients. Results: In our study, the anti-CCP positivity was detected in 15% of PsA group and 4% of healthy controls. The difference was statistically significant (p=0,014; OR=4.24, 95% CI=1.35–13.25). Nine out of 15 anti-CCP positive patients were female, the remaining 6 were male. Thirteen patients (86,7%) had peripheral arthritis, 1 patient (6,7%) had sacroiliitis, 1 patient (6,7%) had peripheral arthritis and sacroiliitis. 42,8% of PsA patients with peripheral arthritis had asymetric olygoarthritis (6/14), 28,5% had monoarthritis (4/14) and 28,5% had symetric polyarthritis (4/14). Anti-CCP antibody positivity had no effect on the involvement of peripheral arthritis. Sacroiliitis and dactilitis were more frequent in the anti-CCP negative group. No patient with dactylitis had anti-CCP positivity (p=0.005). While, 43,5% of RF positive patients were detected anti-CCP positivity, 6,5% of RF negative patients were detected anti-CCP positivity (p=0,000). Conclusions: Our data reveals that anti-CCP positivity is more frequent in PsA compared to HC. We found no statisticall association between anti-CCP positivity and clinical or radiological findings.

Keywords

• Psoriatic Arthritis; Anti-Cyclic Citrullinated Peptide; Rheumatoid Factor

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