Study of antikeratin antibodies in rheumatoid arthritis

ABSTRACT

The aim of this study was to assess the antikeratin antibody [AKA] of IgG class in the sera of patients with rheumatoid arthritis [RA] and its correlation to rheumatoid factor, disease activity, bone erosion and extra-articular manifestations. Also, the effect of different antirheumatic drugs, nonsteroidal anti-inflammatory drugs [NSAIDs] "diclofenac sodium", corticosteroids "prednisolone" and disease modifying antirheumatic drugs [DMARDs] "methotrexate" on IgG AKA titer in RA patients was assessed. This study was carried out on 45 patients with RA diagnosed according to the American College of Rheumatology [1988] criteria. The patients were divided into 3 groups [15 patients each] according to the line of treatment Goup I received diclofenac sodium 100 mg/day for 3 months. Group II received prednisolone 10-20 mg/day for 3 months. Group III received methotrexate 7.5-15 mg/week and folic acid 1mg/day for 3 months. Erythrocyte sedimentation rate, CRP, RF and antikeratin antibody were determined in all patients at the start and at the end of the study. Also, plain x-ray of both hands were done for all patients at study entry. Antikeratin antibody was present in 68.9% of RA patients and it was correlated with parameters of disease activity, RF, CRP and subcutaneous nodules. There was significant reduction in AKA titer after treatment with MTX and prednisolone. The best reduction was in MTX group and it was correlated with improvement in parameters of disease activity. There was no correlation between AKA and degree of bone erosion. The sensitivity of AKA in RA patients is 68.9%. Antikeratin antibodies should be included in the initial investigations for the diagnosis of RA and it can be used as a prognostic marker for the disease and in evaluating the effect of treatment