Anti-cyclic citrullinated peptide [anti-CCP in juvenile idiopathic arthritis [JIA] patients: diagnostic and prognostic value

ABSTRACT

The aim of the study is to investigate the incidence and clinical significance of Anti-CCP antibodies in Juvenile Idiopathic Arthritis [JIA] patients assessing its utility as a serological marker and its relationship with disease subtype and erosive form of the disease. This study comprised twenty-five [17 girls, 8 boys] patients with JIA attending the Rheumatology and Rehabilitation Department in Kasr El-Aini hospitals as well as New children Hospital, Faculty of Medicine, Cairo University. Ten healthy volunteers served as controls. RF positivity was observed only in 9 children with JIA and 7 patients had persistent erosive lesions in their joints. Anti-CCP antibody levels were determined by ELISA and values above 5 relative units [RU] were regarded as positive. Anti-CCP antibodies were found in 10/25 [40%] patients including 8/9 RF positive polyarthritis [88.9% of this subset], 1/2 RF negative polyarthritis, 1/8 pauciarticular arthritis and 0/6 systemic arthritis [p valueAnti-CCP serum samples [p value Anti-CCP antibodies positivity showed significant association with erosive disease and Rheumatoid Factor seropositivity [p value 0.007, 0.001] respectively. There was a non significant correlation of Anti-CCP antibodies with age, disease duration or disease activity scores using DAS28 score. Anti-CCP antibodies can be detected in the sera of patients with JIA but with lower prevalence than that estimated in adult RA in previous studies and is almost exclusively in the subset of patients with polyarticular IgM-RF positive patients. Anti-CCP antibodies in JIA are associated with RF positivity and erosive disease. They could be used as early indices for the more severe disease course with erosive arthritis and joint damage