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Anti-cyclic citrullinated peptide: its prevalence and clinical significance in a South African cohort with juvenile idiopathic arthritis

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Background

Anti-cyclic citrullinated peptide (anti-CCP) antibodies are a highly specific serological marker for adult-onset rheumatoid arthritis, present early in the course of the disease, and are a marker of erosive disease.

Objective

To assess the prevalence and clinical significance of anti-CCP antibodies in a cohort of children with juvenile idiopathic arthritis (JIA).

Methods

A retrospective review of the records of children with JIA attending a paediatric rheumatology clinic at Chris Hani Baragwanath Hospital was undertaken. Anti-CCP antibodies were tested using an enzyme linked immunoabsorbent assay (EliACCP).

Results

Records of 52 patients (54% males, 46% females) were reviewed. The mean (SD) age and follow-up period were 10.69 (3.81) and 2.3 (1.7) years, respectively. The majority of the children (83%) were Black. The subtypes of JIA were as follows: systemic 21%, polyarticular 50%, oligoarticular 19%, enthesitis-related arthritis 2%, psoriatic 2% and other 6%. Anti-CCP antibodies were present in the sera of 8 of 28 patients tested (29%). They were detected exclusively in patients with the polyarticular subtype of JIA. IgM RF was positive in 14 (29.17%) of the total cohort, but not exclusively in patients with the polyarticular subtype of JIA. The overall concordance between the 2 tests was fair (Kappa statistic = 0.39).

Conclusion

Anti-CCP antibodies are present in a high proportion of patients with JIA, and in the polyarticular JIA subtype. They appear to be a better marker of this subtype than IgM RF. The concordance between anti-CCP antibodies and IgM RF in our patients with JIA is fair.

Author information

Correspondence to BJ Mistry.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Mistry, B., Faller, G. & Tikly, M. Anti-cyclic citrullinated peptide: its prevalence and clinical significance in a South African cohort with juvenile idiopathic arthritis. Pediatr Rheumatol 6, P61 (2008) doi:10.1186/1546-0096-6-S1-P61

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Keywords

  • Rheumatoid Arthritis
  • Juvenile Idiopathic Arthritis
  • Serological Marker
  • Total Cohort
  • Paediatric Rheumatology