Extended report
Prevalence and clinical significance of antikeratin antibodies
and other serological markers in Lithuanian patients with rheumatoid
arthritis
L Vasiliauskienea, A Wiikb, M Høier-Madsenb
a Department of
Immunology, Experimental and Clinical Medicine Institute, Vilnius,
Lithuania, b Department of
Autoimmunology, Statens Serum Institut, Copenhagen, Denmark
Correspondence to: Dr A Wiik, Department of Autoimmunology, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark aw{at}ssi.dk
Accepted for publication 17 November
2000
OBJECTIVES
To assess
the clinical value of several serological markers in Lithuanian
patients with rheumatoid arthritis (RA) compared with control patients
with rheumatic disease and age matched healthy controls.
METHODSSerum samples
from 96 patients with RA of approximately 8 years' duration, 90 rheumatic disease controls, and 37 healthy subjects were tested.
Antikeratin antibody (AKA), antineutrophil cytoplasmic antibody
(ANCA), and antinuclear antibody (ANA) titres were estimated by
indirect immunofluorescence (IIF) and serum samples positive for ANA
and ANCA were further studied by enzyme linked immunosorbent assay
(ELISA). IgA and IgM rheumatoid factors (RF) were measured by ELISA.
RESULTSA positive AKA
test was highly specific for RA (diagnostic specificity 97%), being
found in 44% of the patients. Although both RF tests had a higher
sensitivity, they were less specific for RA. ANCA was detected in 33%
of patients with RA but lacked diagnostic specificity. AKA and ANCA
were associated with more erosive disease and the presence of
extra-articular manifestations. Positivity for AKA, IgA RF, and ANCA
was significantly associated with disease activity and worse functional
capacity. However, in multiple regression analysis only positivity for
AKA was significantly correlated with functional disability (p=0.0001),
evaluated by the Steinbrocker functional classification, and no single
marker had any relation with radiological damage.
CONCLUSIONAlthough
AKA showed the highest disease specificity, all serological markers
studied except ANA exhibited interesting associations with important
clinical and paraclinical parameters of RA.
© 2001 by Annals of the Rheumatic Diseases
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