Anti-cyclic citrullinated peptide antibodies in scleroderma patients

Abstract

Anti-CCP (cyclic citrullinated peptide) is considered the most useful laboratory tool in the diagnosis of rheumatoid arthritis (RA). Some authors have also found this autoantibody in patients with scleroderma (SSc). The study aimed to investigate the prevalence of anti-CCP antibodies in SSc patients from Southern Brazil and their association with clinical and serological profile of the disease. We studied 76 patients with SSc and 100 healthy volunteers for presence of anti-CCP. SSc patients charts were reviewed for clinical and laboratory data. In the SSc group, the diffuse form was present in 20.5%; 62.8% had the limited form; 14.1% had overlap with systemic lupus or polymyositis and 2.5% had SSc sine scleroderma. Anti-CCP was found in nine of 78 (11.5%) SSc patients and in one of 100 healthy volunteers (p = 0.0054). No relationship was found with arthritis, skin Rodnan m score, esophageal dysmotility, myocarditis, pulmonary hypertension and lung fibrosis. Positive association was observed with arthralgias (p = 0.02). Also, no relationship was noted with the presence of anti-centromere antibodies, anti-Scl-70, anti-RNP or rheumatoid factor. Anti-CCP are more common in SSc patients than in controls. Arthralgias but not arthritis or rheumatoid factor are more frequent in anti-CCP positive patients.

Anti-CCP antibodies and rheumatoid factor in systemic sclerosis: Prevalence and relationships with joint manifestations

“…Musculoskeletal involvement is present in 24-97% of SSc patients. [1][2][3] A more common manifestation is arthralgia, whereas arthritis is rare. 4,5 Hand involvement is often the first clinical manifestation of SSc.…”

“…6,7 Symmetrical polyarthritis similar to rheumatoid arthritis (RA) can also be found in SSc, but it particularly characterizes a systemic sclerosis-rheumatoid arthritis (SSc-RA) overlap syndrome. 2,[8][9][10] In some cases, arthritis in the course of SSc and SSc-RA overlap syndrome can be very difficult to distinguish. It is known that the main serological markers for diagnosing RA are anti-citrullinated protein (a-CCP) antibodies and rheumatoid factor (RF).…”

Raynaud's Phenomenon, Inflammatory Arthritis, and Weight Loss: Pay Attention to the Man Behind the Curtain

“…The clinical significance of these antibodies in systemic sclerosis is not well understood, since they lack the specificity and sensitivity they have in RA. Surprisingly, anti‐CCP was found in ∼12% and RF was found in 30% of 78 patients with scleroderma in a Brazilian cohort; although CCP seropositivity was related to the prevalence of arthralgia, an association with overt inflammatory arthritis was not demonstrable (). Moreover, none of the 9 CCP‐positive patients in this scleroderma cohort had radiographic evidence of erosive disease.…”

Musculoskeletal Manifestations of Systemic Sclerosis

“…ACPAs on the other hand, are helpful in identifying those patients with SSc who will develop arthralgia and inflammatory arthritis. 16 In particular, ACPA has a sensitivity of 50% to 100% and specificity of 95% in identifying patients with SSc-RA overlap syndrome. 16,17 SSc-RA overlap is a distinct genetic, clinical, and serologic entity and is uncommon in SSc, with a prevalence of 1% to 5%.…”

“…16 In particular, ACPA has a sensitivity of 50% to 100% and specificity of 95% in identifying patients with SSc-RA overlap syndrome. 16,17 SSc-RA overlap is a distinct genetic, clinical, and serologic entity and is uncommon in SSc, with a prevalence of 1% to 5%. 17 However, these patients are more likely to develop bone erosions and joint deformities.…”