Recently, it has been found that some lupus patients may have anti-cyclic citrullinated peptide antibodies (anti-CCP), although the clinical significance of such finding is not well established. Systemic lupus erythematosus (SLE) patients may have joint complaints that are very similar to those observed in rheumatoid arthritis (RA). In early stages of disease, this form of arthritis can be difficult to differentiate from RA, so it is not rare that some SLE patients are initially misdiagnosed to have this disease. This study aims to investigate the prevalence of anti-CCP in SLE patients from Southern Brazil and its association with clinical and serological profiles. One hundred nine SLE patients were studied for anti-CCP and compared with data of 156 RA patients and 100 healthy volunteers. Comparison of clinical and autoantibody profile of anti-CCP-positive and anti-CCP-negative SLE patients was done. All SLE patients positive of anti-CCP were submitted to hand and feet X-rays. Anti-CCP was positive in 15 of 109 SLE patients, and one of them had confirmed the diagnosis of rhupus. This prevalence was significantly higher than in healthy controls (p = 0.0004) and lower than in RA patients (p < 0.0001). No relationship could be found with clinical profile, including joint complaints. SLE patients with anti-CCP had higher prevalence of anti-Ro (p = 0.02) and anti-La (p = 0.004) autoantibodies, in comparison with those negative to anti-CCP. We found that 13.7% of Brazilian patients with SLE have positive anti-CCP. Patients with anti-CCP showed higher prevalence of anti-Ro and anti-La autoantibodies than those negative for anti-CCP. Only a careful and prolonged follow-up will reveal the real clinical value of these markers in each patient individually.
Only IgA-EmA was significantly associated with lupus and with the presence of discoid lesions. Until now, no obvious association with celiac disease has been found.
Background Chronic inflammatory diseases lead to glycation of protein, lipids and nuclear acids. One product generated in this context is pentosidine. Aim To study pentosidine levels in Systemic Lupus Erythematosus (SLE) and its possible association with disease activity and cumulative damage. Methods Pentosidine serum levels were measured in the serum by ELISA commercial kits in 79 patients with SLE. Disease activity index and cumulative damage were studied by SELENA-SLEDAI (Safety of Estrogen in Lupus National Assessment Systemic Lupus Erythematosus Disease Activity Index) and cumulative damage by SLICC/ACR DI (Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for Systemic Lupus Erythematosus) respectively and simultaneously with determination of pentosidine levels. Epidemiological and clinical and serological profile were collected from the charts. Results In the 79 studied patients, the SLEDAI ranged from 0 to 12 (median of 0) and the SLICC/ACR-DI from 0 to 4 (median of 0). Serum pentosidine levels did not correlate with SLEDAI neither with SLICC. Patients with discoid skin lesions and photosensitivity had lower levels than those without them, with p = 0.04 in both. Conclusion In SLE, serum pentosidine levels did not reflect activity and cumulative damage. Patients with skin manifestations had lower levels of this biomarker.
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