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MODERN RHEUMATOLOGY Vol.14 No.5
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| Anticyclic citrullinated peptide antibodies in patients with mixed connective tissue disease |
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| Yoshinari Takasaki1, Kenjiro Yamanaka1,2, Chiho Takasaki1,2, Masakazu Matsushita1, Hirofumi Yamada1, Masuyuki Nawata1, Ran Matsudaira1, Keigo Ikeda1, Kazuhiko Kaneda1 and Hiroshi Hashimoto1 |
(1) Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
(2) Division of Internal Medicine, Kyoundo Hospital, Tokyo, Japan |
Received: 29 March 2004 Accepted: 28 June 2004 |
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Abstract |
| The clinical significance of anticyclic citrullinated peptide (CCP) antibodies in patients with mixed connective tissue disease (MCTD) was assessed. Altogether, 86 sera from MCTD patients, 96 from rheumatoid arthritis (RA) patients, 42 from systemic lupus erythematosus (SLE) patients, 23 from systemic sclerosis (SSc) patients, 21 from poymyositis/dermatomyositis (PM/DM) patients, and 17 from those with Sjogren's syndrome (SjS) were tested for anti-CCP antibodies using an enzyme-lined immunosorbent assay. Among the 96 RA patients, anti-CCP antibodies were detected in 85%, with the frequency being significantly higher than in MCTD, SLE, SSc, PM/DM, and SjS patients (9%, 14%, 13%, 14%, and 18%, respectively; P < 0.001). Among eight MCTD patients who fulfilled the diagnostic criteria for RA, only 50% had anti-CCP antibodies, and the prevalence was significantly lower than for all RA patients (p < 0.01). All eight patients who fulfilled the criteria for RA had overlap of SLE and SSc, except one patient, whereas the four anti-CCP-positive patients who did not fulfill the criteria for RA had SjS without overlapping features of SLE and SSc; moreover, most of their antibody titers were low. These results suggested that anti-CCP antibodies are associated with RA in MCTD patients, but careful diagnosis of RA is required if patients with low titers of anti-CCP antibodies lack overlapping SLE and SSc. |
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| Key words |
| Autoantibody - Cyclic citrullinated peptide (CCP) - Mixed connective tissue disease (MCTD) - Rheumatoid arthritis (RA) |
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