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Anti-Cyclic Citrullinated Peptide (Anti-CCP) Antibodies in Children with Juvenile Idiopathic Arthritis
MARION VAN ROSSUM, RENÉE VAN SOESBERGEN, SANDRA DE KORT, REBECCA TEN CATE, AEILKO H. ZWINDERMAN, BEN DE JONG, BEN DIJKMANS, and WALTHER J. VAN VENROOIJ
ABSTRACT.
Methods. One hundred serum samples of 71 patients with JIA taken at different time points in their disease course were analyzed by a commercially available anti-CCP ELISA. Followup serum samples from 28 patients were also tested. Correlations between anti-CCP and disease characteristics, medication, and radiological damage (presence of joint space narrowing and/or erosions) were also determined. Results. The serum samples came from patients of all 8 different subtypes of JIA (mean age: 9.6 years, median: 10.5; disease duration mean: 39 months, median: 24) including 11 polyarticular rheumatoid factor positive (IgM-RF) patients. Anti-CCP was positive in 73% of the IgM-RF positive JIA patients and in 3% of the other JIA patients (p < 0.0001). Disease duration, medication, and anti-nuclear antibody positivity did not differ significantly between anti-CCP positive and negative patients. Testing of followup samples showed almost identical anti-CCP results. All IgM-RF positive JIA patients had radiological damage (p < 0.001). Of the anti-CCP positive patients, 80% had radiological damage resulting in a significant difference between anti-CCP positive and negative patients (p = 0.009) with an odds ratio (OR) of 12.7, but corrected for IgM-RF, the OR was no longer significant (p = 0.88). Conclusion. Anti-CCP antibodies can be detected in the sera of patients with JIA but almost exclusively in the subset of patients with polyarticular IgM-RF. (J Rheumatol 2003;30:825-8) Key Indexing Terms:
JUVENILE IDIOPATHIC ARTHRITIS
From the Department of Pediatrics, Leiden University Medical Center, Leiden; the Department of Rheumatology, Slotervaart Hospital, the Department of Rheumatology, Jan van Breemen Instituut, the Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, and the Department of Rheumatology, VU University Medical Center, Amsterdam; the Department of Biochemistry 161, NCMLS, University of Nijmegen, Nijmegen, The Netherlands. The work of W.J. van Venrooij is supported by Het Nationaal Reumafonds of The Netherlands (the Dutch League against Rheumatism), The Netherlands Foundation for Research (NWO grant 940-35-037), and The Netherlands Technology Foundation (grant 349-5077). M.A.J. van Rossum, MD, Pediatric-Rheumatologist, Department of Pediatrics, Leiden University Medical Center; R.M. van Soesbergen, MD, PhD, Rheumatologist, Department of Rheumatology, Slotervaart Hospital; S.W.K. de Kort, MD, Trainee Pediatrics; R. ten Cate, MD, PhD, Pediatric-Rheumatologist, Department of Pediatrics, Leiden University Medical Center; A.H. Zwinderman, MSc, PhD, Professor of Epidemiology and Biostatistics, Department of Clinical Epidemiology and Biostatistics, Academic Medical Center; B.A.C. Dijkmans, MD, PhD, Professor of Rheumatology, Department of Rheumatology, VU University Medical Center; B.A.W. de Jong, Biochemist; W.J. van Venrooij, PhD, Professor of Biochemistry, Department of Biochemistry 161, NCMLS, University of Nijmegen. Address reprint requests to Dr. A.J. van Rossum, Leiden University Medical Center, J-6-S, Department of Pediatrics PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: m.van_rossum@lumc.nl Submitted May 28, 2002; revision accepted June 28, 2002. |