Anti-CCP antibodies as a marker of rhupus

Abstract

Anti-CCP antibodies as a marker of rhupus Sir,We have read with interest the works on rhupus, a clinical condition characterized by the coexistence of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), recently published in Lupus. 1,2 These publications prompted us to investigate the prevalence and characteristics of rhupus in our cohort of patients with SLE, 3,4 fulfilling international classification criteria. 5,6 This was a cross-sectional analytical study conducted in 377 Colombian patients with SLE and undertaken between February 1996 and June 2013. The patients' sociodemographic and cumulative clinical and laboratory data were obtained by interview, standardized report form, physical examination and chart review. The variables were registered at any time during the course of the disease as described elsewhere. 3,4 Likewise, the relevant laboratory variables associated with SLE were recorded. 3,4 All of the patients underwent antibodies determination, including IgM rheumatoid factor (RF) and IgG anti-cyclic citrullinated peptide (anti-CCP3), as described elsewhere. 3,4 Factors associated with rhupus were assessed by bivariate analysis and classification and regression trees (CART) analysis, with complex interactions not captured by logistic regression. The variables included in the statistical model were polyautoimmunity and multiple autoimmune syndrome, familial autoimmunity, gender, age at onset, smoking and coffee consumption, toxic exposure, comorbidities, cardiovascular disease, history of infections, malar rash, discoid rash, photosensitivity, oral ulcers, positive antinuclear antibody, arthritis, serositis, renal, neurologic, hematologic and immunologic disorder. 3,4 Likewise, positivity for antibodies, lupus anticoagulant and complement status were variables also included. The statistical analyses

Need for Greater Attention to Joint Damage in Rhupus Patients: Results from an Ultrasound Study

“…Patients with rhupus syndrome have been reported to have ANA, dsDNA, RF, and anti-CCP antibodies [ 16 ]. In the present study, the positive rates of anti-CCP and titer of anti-CCP were significantly higher in rhupus patients than in the SLE with arthropathy group, which agrees with some previous studies [ 17 , 18 ]. Anti-CCP antibodies have been shown to play an essential diagnostic role in patients with rhupus symptom and may increase the risk of erosive arthritis in RS patients [ 19 ].…”

Antibodies against carbamylated proteins and cyclic citrullinated peptides in systemic lupus erythematosus: results from two well-defined European cohorts

“…The presence of anti-CCP antibodies is considered highly specific for RA, but can also be found in other conditions, including SLE, where frequencies from 2–17% have been described [9, 32, 45–51]. Whether or not there is a true association between a positive anti-CCP test and erosive arthritis in SLE remains an open question, as several investigators have reported this [9, 46–50], whereas others have not [31, 45]. Kakumanu et al reported a prevalence of 17% for anti-CCP positivity among 329 patients with SLE but that citrulline-dependent anti-CCP was mainly found in patients with erosive arthritis, which involved only 26 patients [9].…”

Comparison of Plasma Cytokine Levels before and after Treatment with Rituximab in Patients with Rheumatoid Arthritis and Systemic Lupus Erythematosus-Associated Polyautoimmunity

“…Furthermore, RTX therapy has been effective in SS (38) and cytokine levels show a significant decrease after therapy (39). RA may also be associated with PolyA (2) and its coexistence with SLE is known as Rhupus, with a prevalence as high as 10% in SLE patients (40,41). RTX has been shown to improve the clinical presentation for both entities (42).…”