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Contribution of antiferritin antibodies to diagnosis of giant cell arteritis
  1. Alexis Régent1,2,
  2. Kim Heang Ly3,4,
  3. Aurélie Blet1,
  4. Christian Agard5,
  5. Xavier Puéchal1,2,
  6. Nicolas Tamas1,
  7. Claire Le-Jeunne6,
  8. Elisabeth Vidal3,4,
  9. Loïc Guillevin2,
  10. Luc Mouthon1,2
  1. 1 Institut Cochin, INSERM U1016, CNRS UMR 8104, Université Paris Descartes, Paris, France
  2. 2 Pôle de Médecine Interne, Centre de Référence pour les vascularites nécrosantes et la sclérodermie systémique, Hôpital Cochin, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
  3. 3 Service de Médecine Interne A, CHU Dupuytren, Limoges, France
  4. 4 Laboratoire d'immunologie, EA3842, Faculté de médecine, Limoges, France
  5. 5 Service de Médecine Interne, Hôpital Hôtel Dieu, Nantes, France
  6. 6 Service de Médecine Interne, Hôpital Hôtel Dieu, AP-HP, Paris, France
  1. Correspondence to Dr Alexis Régent, Service de Médecine Interne, Hôpital Cochin, 27 rue du faubourg Saint-Jacques, 75679 Paris, Cedex 14, France; alexisregent{at}hotmail.com

https://doi.org/10.1136/annrheumdis-2012-202963

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    Establishing the diagnosis of giant cell arteritis (GCA) may be challenging. In the absence of validated biological marker1 and despite imaging technique contribution,2 the diagnosis of GCA currently relies on temporal artery biopsy (TAB). Autoantibodies have been identified in GCA3–6 and recently, Baerlecken et al 7 detected IgG antibodies directed against a peptide of the human ferritin heavy chain (FTH1) in 92% of untreated GCA and polymyalgia rheumatica at first diagnosis versus 1% of healthy controls (HC).

    In order to evaluate the diagnosis value of these antibodies, we tested sera from 122 consecutive patients suspected of GCA at the time of TAB. Based on the American College of Rheumatology (ACR) criteria,8 40 patients had biopsy-proven GCA (TAB+GCA), 29 patients had biopsy-negative GCA (TAB−GCA), 47 patients received another diagnosis than GCA (GCA controls) and 6 patients had polymyalgia rheumatica (collection dc-2010–1079). Sera from 40 healthy blood donors were used as HCs. All patients and controls gave signed informed consent. The study was approved by the ethics …

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    Footnotes

    • Contributors AR designed the experiments, carried out the ELISA experiments, analysed the results and drafted the manuscript. KHL provided sera from patients, participated in the analysis of the results and edited the manuscript. AB carried out ELISA experiments with AR and edited the manuscript.CA provided sera from patients, participated in the analysis of the results and edited the manuscript. XP participated in the study design and edited the manuscript. NT carried out ELISA experiments with AR and edited the manuscript. CLJ provided sera from patients, participated in the analysis of the results and edited the manuscript. EV provided sera from patients, participated in the analysis of the results and edited the manuscript. LG provided sera from patients, participated in the study design and analysis of the results and also edited the manuscript. LM provided sera from patients, designed the experiments, analysed the results and drafted the manuscript.

    • Competing interests AR and LM have applied for a patent for a diagnostic test of vasculitic disorders including giant cell arteritis (US 20120088257).

    • Ethics approval The ethics committee of Cochin hospital.

    • Provenance and peer review Not commissioned; externally peer reviewed.