Contribution of anti-cyclic citrullinated peptide antibody and rheumatoid factor to the diagnosis of arthropathy in haemochromatosis

• Published in: Annals of the rheumatic diseases Vol. 66; no. 9; pp. 1249 - 1251
• Main Authors: Aigner, E, Schmid, I, Österreicher, C H, Zwerina, J, Schett, G, Strasser, M, Niksic, F, Hohla, F, Ramsauer, T, Dorn, U, Patsch, W, Datz, C
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.09.2007; BMJ; Elsevier Limited; BMJ Group
• Subjects: ACR; Adolescent; Adult; Aged; American College of Rheumatology; anti-CCP; Arthritis, Rheumatoid - diagnosis; Arthritis, Rheumatoid - immunology; arthropathy; Autoantibodies - blood; Biological and medical sciences; Biomarkers - blood; Case-Control Studies; CCP; Chi-Square Distribution; Concise Report; cyclic citrullinated peptide antibodies; Diagnosis, Differential; Diseases of the osteoarticular system; Enzyme-Linked Immunosorbent Assay; Female; haemochromatosis; Health risk assessment; Hemochromatosis - blood; Hemochromatosis - complications; Hemochromatosis - immunology; Hemochromatosis Protein; hereditary haemochromatosis; HHC; Histocompatibility Antigens Class I - genetics; Homozygote; Humans; Inflammatory joint diseases; Joint Diseases - blood; Joint Diseases - etiology; Joint Diseases - immunology; Male; Medical sciences; Membrane Proteins - genetics; Metabolic diseases; Metals (hemochromatosis...); Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Mutation; Other metabolic disorders; Patients; Peptides, Cyclic - immunology; Point Mutation; Prevalence; Rheumatism; Rheumatoid arthritis; rheumatoid factor; Rheumatoid Factor - blood; Sensitivity and Specificity; Human; Immunopathology; Hemochromatosis; Peptides; Antibody; Diseases of the osteoarticular system; Autoimmune disease; Metabolic diseases; Inflammatory joint disease; Arthritis; Iron; Joint; Enzymopathy; Rheumatoid factor; Chronic; Rheumatoid arthritis; Arthropathy; Diagnosis; ELISA assay
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.2007.071621

Objective: To investigate the prevalence of antibodies to cyclic citrullinated peptide (anti-CCP) and rheumatoid factor in patients with hereditary haemochromatosis (HHC) and to evaluate their diagnostic reliability in distinguishing HHC-associated arthropathy from rheumatoid arthritis. Methods: Anti-CCP antibodies and rheumatoid factor levels were determined by ELISA in sera from 87 patients with HHC homozygous for the C282Y mutation of the HFE gene, 31 patients with rheumatoid arthritis and 162 healthy controls. Results: Of the 87 patients with HHC, 32 (36.8%) had joint involvement. Anti-CCP antibodies were detected in only 1 patient (1.1%) with HHC, who had no joint disease, and in (1.2%) healthy controls. In total, 18 (58.1%) patients with rheumatoid arthritis displayed anti-CCP reactivity (p<0.001). Rheumatoid factor was detected in 10 (11.5%) patients with HHC compared with 7 (4.3%) healthy control subjects (p = 0.03) and 21 of 31 (65.6%) patients with rheumatoid arthritis. Conclusions: Testing for anti-CCP antibodies discriminates HHC arthropathy from rheumatoid arthritis, as these patients were consistently anti-CCP negative. Thus, HHC arthropathy should be considered in the differential diagnosis of CCP-negative arthritis.