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Citrulline dependence of anti-cyclic citrullinated peptide antibodies in systemic lupus erythematosus as a marker of deforming/erosive arthritis
Journal of Rheumatology, 11/06/09

Kakumanu P et al. – Conclusion Citrulline dependence or high levels (> 10) of anti-CCP were common in SLE patients with deforming/erosive arthritis, while most anti-CCP in SLE patients was citrulline-independent. This may be useful in identifying a subset of SLE patients with high risk for development of deforming/erosive arthritis.

Methods

IgG anti-CCP compared by ELISA to anti-CAP in sera from patients with SLE (n = 335) and RA (n = 47) and healthy controls (n = 35)
SLE patients were divided into 5 groups based on their joint involvement: subset I: deforming/erosive arthritis (n = 20); II: arthritis fulfilling (or likely fulfilling) American College of Rheumatology criteria for RA but without erosions (n = 18); III: joint swelling but not fulfilling RA criteria (n = 39); IV: arthritis without documented joint swelling (n = 194); and V: no arthritis (n = 58)

Results

Anti-CCP (> 1.7 units) found in 68% (32/47) of patients with RA and 17% (55/329) of those with SLE
More common in SLE patients with deforming/erosive arthritis (38%)
High anti-CCP (> 10 units) was found in RA (26%) and deforming/erosive SLE (12%)
High anti- CCP/CAP ratios (> 2, indicating a selectivity to CCP) were found in 91% of anti-CCP-positive RA and 50% of anti-CCP-positive SLE patients with deforming/erosive arthritis
Patients from subset II did not have high anti-CCP/CAP