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Evaluation of rheumatoid factor and anti‐citrullinated peptide antibodies in relation to rheumatological manifestations in patients with leprosy from Southern Brazil
Author(s) -
Dionello Carla Fontoura,
Rosa Utiyama Shirley Ramos,
Radominski Sebastião Cézar,
Stahlke Ewalda,
Stinghen Servio Tulio,
MessiasReason Iara Jose
Publication year - 2016
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12668
Subject(s) - medicine , leprosy , rheumatoid arthritis , rheumatoid factor , antibody , arthritis , immunology , gastroenterology , dermatology
Abstract Background Leprosy patients may present several osteoarticular complaints, which require further evaluation of inflammatory diseases, such as rheumatoid arthritis ( RA ). Therefore, an adequate clinical assessment in addition to testing for rheumatoid factors ( RF ) and anticyclic citrullinated peptide antibodies (anti‐ CCP ), can be useful in order to establish the correct diagnosis. Method In this study, the relation of RF and anti‐ CCP with rheumatological manifestations was evaluated in 97 leprosy patients from Southern Brazil. The results were compared to RA patients and healthy controls from the same geographical area and ethnic background. Results Neuropathy was observed in 71.1% and arthritis in 35.1% of the leprosy patients. A high frequency of RF positivity was observed among the leprosy patients (41.2%, 40/97), with RF immunoglobulin A (IgA) significantly associated with arthritis ( OR = 7.9, 95% CI = 1.5–40.6 P = 0.008). Anti‐ CCP was observed in 9.3% (9/97) of the patients, with anti‐ CCP 2 being the most frequent subtype. Only 4.1% (4/97) of the patients were RF and anti‐ CCP concomitantly positive. RF IgM showed a significant association with leprosy when compared to healthy controls ( P < 0.0001) whereas for anti‐ CCP 2 no significant results were observed ( P = 0.0585). However, both biomarkers showed a strong association with RA when compared to leprosy in patients from the same geographical area and ethnic background (anti‐ CCP 2 OR = 38.6; 95% CI = 16.49–90.26; P < 0.0001 and RF IgM OR = 4.51; 95% CI = 2.62–7.77; P < 0.0001). Conclusion Due to the similarity of some rheumatological manifestations in leprosy with other inflammatory diseases, such as RA , clinical and laboratorial evaluation of affected patients must be carefully assessed in order to achieve proper diagnosis and treatment.