RESEARCH - Presence of anti-CCP antibodies in patients with rhupus

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Arthritis Res Ther. 2006; 8(5): R144.

Presence of antibodies against cyclic citrullinated peptides in

patients with 'rhupus': a cross-sectional study

M Amezcua-Guerra,1 Rashidi Springall,1 Marquez-Velasco,1

Gómez-García,1 Angélica Vargas,2 and Bojalil1,3

1Department of Immunology, Instituto Nacional de Cardiología Ignacio

Chávez, Badiano 1, Sección XVI, Tlalpan 14080, Mexico City,

Mexico

2Department of Rheumatology, Instituto Nacional de Cardiología Ignacio

Chávez, Badiano 1, Sección XVI, Tlalpan 14080, Mexico City,

Mexico

3Department of Health Care, Universidad Autónoma Metropolitana

Xochimilco, Calzada del Hueso 1100, Villa Quietud, Coyoacán 04960,

Mexico City, Mexico

Abstract

'Rhupus' is a rare condition sharing features of rheumatoid arthritis

(RA) and systemic lupus erythematosus (SLE). If rhupus is a

distinctive entity, an overlap between RA and SLE or a subset of SLE

is currently debated. This study was performed to explore the

prevalence of antibodies against cyclic citrullinated peptides

(anti-CCP antibodies) in rhupus. Patients meeting American College of

Rheumatology criteria for RA, SLE, or both were included. Clinical and

radiographic features were recorded and sera were searched for

anti-CCP antibodies, rheumatoid factor, antinuclear antibodies,

anti-extractable nuclear antigens, and antibodies against

double-stranded DNA (anti-dsDNA antibodies). Seven patients for each

group were included. Clinical and serological features for RA or SLE

were similar between rhupus and RA patients, and between rhupus and

SLE patients, respectively. Values for anti-CCP antibodies obtained

were significantly (p < 0.05) higher in RA (6/7) and rhupus (4/7) than

in SLE patients (0/7) and healthy subjects (0/7). Our data support the

possibility that rhupus is an overlap between RA and SLE, because

highly specific autoantibodies for RA (anti-CCP) and for SLE

(anti-dsDNA and anti-Sm) are detected in coexistence.

Introduction

The clinical coexistence of rheumatoid arthritis (RA) and systemic

lupus erythematosus (SLE) was first described in 1969 by Kantor and

was termed 'rhupus syndrome' by Schur (both cited in [1]). Since then,

fewer than 100 cases of rhupus have been published [1-3]. In an

epidemiological study including about 7,000 new patients, the

prevalence of RA was 15% and for SLE it was 8.9%. The expected

coincidence of RA and SLE by chance would therefore be 1.2%. However,

the observed prevalence of rhupus was 0.09%, less than one-tenth of

that expected [1].

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Read the full article here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1779435/

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