Email Alert | RSS

Journal of Peking University (Health Sciences) ›› 2020, Vol. 52 ›› Issue (6): 1023-1028. doi: 10.19723/j.issn.1671-167X.2020.06.006

Previous Articles     Next Articles

Clinical and laboratory characteristics of rheumatoid arthritis with positive antinuclear antibody

Jing-feng ZHANG,Xiu-ling YE,Meng DUAN,Xiao-li ZHOU,Zhong-qiang YAO,Jin-xia ZHAO()   

  1. Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, China
  • Received:2020-06-12 Online:2020-12-18 Published:2020-12-13
  • Contact: Jin-xia ZHAO E-mail:zhao-jinxia@163.com

RICH HTML

   

PDF (PC)

Abstract:

Objective: To analyse the clinical and laboratory characteristics of antinuclear antibody (ANA) positive rheumatoid arthritis (RA) patients. Methods: The clinical and laboratory data of 428 RA cases from Department of of Rheumatology and Immunology Peking University Third Hospital from Jan 2013 to Dec 2018 were collected and used to analyse characters between ANA positive group and ANA negative group. T test was used for the quantitative data in accordance with normal distribution. Wilcoxon rank sum test was used for the quantitative data of non normal distribution. The qualitative data were analyzed by chi square test. But while 1≤theoretical frequency<5, chi square test of corrected four grid table was used. And Fisher exact probability method was used when theoretical frequency<1. Results: The number of ANA positive group was 231 (54%). The female rate was obviously higher in ANA positive group (82.7% vs. 63.5%, χ2=20.355,P<0.01). The rate of metatarsophalangeal joints (MTPJs) involvement was lower in ANA positive group (22.1%) than in ANA negative group (33.0) (χ2=6.414, P<0.05). The incidence of secondary Sj?gren’s syndrome (sSS) was much higher in ANA positive group(19.5% vs. 4.1%, χ2=23.300,P<0.01). The positivity of rheumatoid factor (RF), as well as the positivity of anti-cyclic citrullinated peptide(CCP) antibody was much higher in ANA positive group (77.1% vs. 53.8%, χ2=25.743,P<0.01, 74.9% vs. 59.4%, χ2=11.694,P<0.01, respectively). The levels of immunoglobulin G (IgG) and immunoglobulin M (IgM) of ANA positive group were higher [(15.1±5.1) g/L vs. (13.8±5.3) g/L, t=2.359, P<0.05, 1.25 (0.92) g/L vs. 1.05 (0.65) g/L, Z=-3.449, P<0.01, respectively]. But the levels of hemoglobin (Hb) and platelet (PLT) was lower in ANA positive group[ (109.64±17.98) vs. (114.47±18.48) g/L,t=-2.734, P<0.01; (266.4×109±104.6×109) vs. (295.9×109±100.1×109) /L,t=-2.970, P<0.01, respectively]. Conclusion: The incidence of sSS was obviously higher in ANA positive group than in ANA negative group. Serum IgG of ANA positive group was higher, but Hb and PLT were lower.

Key words: Rheumatoid arthritis, antinuclear antibody, Secondary Sj?gren's syndrome, Rheumatoid factor, anti-cyclic citrullinated peptide antibody

CLC Number: 

  • R593.22

Table 1

Comparison of general situation between ANA+ RA group and ANA- RA group"

Group Number of cases Age/years, M(QR) Gender(female), n(%) Disease duration/years, M(QR) Somking history, n(%)
ANA+ 231 60.0(18.0) 191 (82.7) 5.0 (16.0) 36 (15.6)
ANA- 197 61.0(16.0) 125 (63.5) 5.0 (12.2) 46 (23.4)
Z/χ2 -0.450 20.355 -1.401 4.140
P 0.653 <0.001 0.161 0.042

Table 2

Comparison of joint performance between ANA+ RA group and ANA- RA group"

Group ANA+ ANA- t/Z/χ2 P
Number of cases 231 197
DIPJs, n(%) 16 (6.9) 17 (8.6) 0.433 0.51
PIPJs, n(%) 155 (67.1) 138 (70.0) 0.429 0.513
MCPJs, n(%) 134 (58.0) 121 (61.4) 0.514 0.473
Wrist joints, n(%) 148 (64.1) 136 (69.0) 1.175 0.278
Elbow joints, n(%) 92 (39.8) 89 (45.2) 1.247 0.264
Shoulder joints, n(%) 88 (38.1) 77 (39.1) 0.044 0.834
TMJs, n(%) 4 (1.7) 7 (3.6) 1.409 0.235
Sternoclavicular joints, n(%) 2 (0.9) 1 (0.5) 0 1.000
Hip joints, n(%) 41 (17.7) 36 (18.3) 0.02 0.888
Knee joints, n(%) 165 (71.4) 136 (69.0) 0.292 0.589
Ankle joints, n(%) 114 (49.4) 107 (54.3) 1.049 0.306
MTPJs, n(%) 51 (22.1) 65 (33.0) 6.414 0.011
PIPJs(F), n(%) 23 (10.0) 22 (11.2) 0.166 0.684
DIPJs(F), n(%) 0 (0.0) 2 (1.0) 0.211
Tender joint count, M(QR) 11.0 (19.0) 9.0 (13.0) -1.096 0.273
Swollen joint count, M(QR) 5.0 (10.0) 5.0 (12.0) -0.055 0.956
Joint deformity, n(%) 75 (32.5) 65 (33.0) 0.013 0.908
Symmetry, n(%) 222 (96.1) 191 (97.0) 0.227 0.633
VAS, M(QR) 5.0 (5.5) 5.0 (5.0) -1.317 0.188
DSA28, x±s 5.4±1.5 5.3±1.5 1.331 0.184

Table 3

Comparison of extraarticular manifestations between ANA+ RA group and ANA- RA group"

Group Number
of cases		 Vasculitis, n(%) Rheumatoid
nodules, n(%)		 Peripheral
neuropathy, n(%)		 Pericarditis, n(%) Pleural
effusion, n(%)		 ILD, n(%) Anemia, n(%)
ANA+ 231 2 (0.9) 18 (7.8) 5 (2.2) 6 (2.6) 9 (3.9) 53 (22.9) 120 (51.9)
ANA- 197 0 (0.0) 10 (5.1) 4 (2.0) 0 (0.0) 4 (2.0) 47 (23.9) 92 (46.7)
χ2 1.283 0.000 3.481 1.257 0.05 1.171
P 0.502 0.257 1.000 0.062 0.262 0.824 0.279

Table 4

Comparison of complications between ANA+ RA group and ANA- RA group"

Group Number of cases sSS, n(%) Venous thrombosis, n(%)
ANA+ 231 45 (19.5) 8 (3.5)
ANA- 197 8 (4.1) 8 (4.1)
χ2 23.300 0.106
P <0.001 0.745

Table 5

Comparison of laboratory examination indexes between ANA+ RA group and ANA- RA patients"

Group ANA+ ANA- t/Z/χ2 P
Number of cases 231 197
RF, n(%) 178 (77.1) 106 (53.8) 25.743 <0.001*
anti-CCP antibody, n(%) 173 (74.9) 117 (59.4) 11.694 0.001*
AKA, n(%) 51 (25.5) 30 (17.9) 3.107 0.078
WBC/(×109/L), M(QR) 6.35 (3.56) 6.74 (2.64) -1.955 0.051
Hb/(g/L), x-±s 109.6±18.0 114.5±18.5 -2.734 0.007*
PLT/(×109/L),x-±s 266.4±104.6 295.9±100.1 -2.970 0.003*
IgG/(g/L), x-±s) 15.1±5.1 13.8±5.3 2.359 0.019*
IgA/(g/L), M(QR) 3.01 (1.96) 2.89 (2.33) -1.217 0.224
IgM/(g/L), M(QR) 1.25 (0.92) 1.05 (0.65) -3.449 0.001*
C3/(g/L), M(QR) 1.03 (0.35) 1.05 (0.33) -0.719 0.472
C4/(g/L), x-±s 0.22±0.09 0.23±0.09 -1.299 0.195
ESR/(mm/h), M(QR) 44.0 (51.0) 42.0 (56.5) -1.104 0.270
CRP/(mg/dL), M(QR) 2.05 (5.42) 2.40 (6.64) -0.645 0.519
[1] Kavanaugh A, Tomar R, Reveille J, et al. Guidelines for clinical use of the anti-nuclear antibody test and tests for specific autoantibodies to nuclear antigens[J]. Arch Pathol Lab Med, 2000,124(1):71-81.
pmid: 10629135
[2] Nishimura S, Nishiya K, Hisakawa N, et al. Positivity for antinuclear antibody in patients with advanced rheumatoid arthritis[J]. Acta Medica Okayama, 1996,50(5):261-265.
doi: 10.18926/AMO/30501 pmid: 8914679
[3] Torre IG, Mendez LM. Studies of antinuclear antibodies in rheumatoid arthritis[J]. J Rheumatol, 1982,9(4):603-606.
pmid: 6182293
[4] Aitcheson CT, Peebles C, Joslin F, et al. Characteristics of antinuclear antibodies in rheumatoid arthritis[J]. Arthritis Rheum, 1980,23(5):528-538.
doi: 10.1002/art.1780230503 pmid: 6990933
[5] Marques RC, Bogas M, Ramos F, et al. Prognostic value of antinuclear antibodies in juvenile idiopathic arthritis and anterior uveitis. Results from a systematic literature review[J]. Acta Reumatol Port, 2014,39(2):116-122.
pmid: 24879943
[6] Hügle B, Hinze C, Lainka E, et al. Development of positive antinuclear antibodies and rheumatoid factor in systemic juvenile idiopathic arthritis points toward an autoimmune phenotype later in the disease course[J]. Pediatr Rheumatol, 2014,12(1):28.
doi: 10.1186/1546-0096-12-28
[7] Fernandez SAV, Lobo AZC, Oliveira ZNP, et al. Prevalence of antinuclear autoantibodies in the serum of normal blood donors[J]. Rev Hosp Clin, 2003,58(6):315-319.
doi: 10.1590/S0041-87812003000600005
[8] Racoubian E, Zubaid RM, Shareefd MA, et al. Prevalence of antinuclear antibodies in healthy Lebanese subjects, 2008-2015: a cross-sectional study involving 10 814 subjects[J]. Rheumatol Int, 2016,36(9):1231-1236.
pmid: 27432022
[9] Bienenstock H. Rheumatoid plantar synovial cysts[J]. Ann Rheum Dis, 1975,34(1):98-99.
doi: 10.1136/ard.34.1.98 pmid: 1124961
[10] Antero DC, Parra AGM, Miyazaki FH, et al. Secondary Sjögren’s syndrome and disease activity of rheumatoid arthritis[J]. Rev Assoc Méd Bras(English Edition), 2011,57(3):313-316.
[11] Al-Osami MH, Allawi AAM, Al-Saadawi TH. The association of smoking with the extra-articular manifestations in rheumatoid arthritis patients[J]. Postgrad Med J, 2013,12(1):146-152.
[12] Kuller LH, Mackey RH, Walitt BT, et al. Rheumatoid arthritis in the women health initiative: methods and baseline evaluation[J]. Am J Epidemiol, 2014,179(7):917-926.
doi: 10.1093/aje/kwu003 pmid: 24569640
[13] Tellides G, Pober JS. Inflammatory and immune responses in the arterial media[J]. Circ Res, 2015,116(2):312-322.
doi: 10.1161/CIRCRESAHA.116.301312 pmid: 25593276
[14] Aghdashi MA, Khadir M, Dinparasti-Saleh R. Antinuclear antibodies and lupus-like manifestations in rheumatoid arthritis and ankylosing spondylitis patients at 4 months’ follow-up after treatment with infliximab and etanercept[J]. Curr Rheumatol Rev, 2020,16(1):61-66.
doi: 10.2174/1573397115666190506152729 pmid: 31057111
[15] Yukawa N, Fujii T, Ishikawa SK, et al. Correlation of antinuclear antibody and anti-double-stranded DNA antibody with clinical response to infliximab in patients with rheumatoid arthritis: a retrospective clinical study[J]. Arthritis Res Ther, 2011,13(6):R213.
doi: 10.1186/ar3546 pmid: 22192852
[1] Hui WEI, Jingfeng ZHANG, Zhongqiang YAO, Jinxia ZHAO. Clinical characteristics and relevant factors of rheumatoid arthritis patients with anemia of chronic disease [J]. Journal of Peking University (Health Sciences), 2026, 58(2): 307-312.
[2] Tao WU, Jianzi LIN, Yafeng ZHU, Jianda MA, Peiwen JIA, Lijuan YANG, jie PAN, Yaowei ZOU, Ying YANG, Ye LU, Lie DAI. Serum inter-alpha-trypsin inhibitor heavy chain H3 is identified as a potential biomarker for myopenia in patients with rheumatoid arthritis using proteomic profiling [J]. Journal of Peking University (Health Sciences), 2025, 57(6): 1024-1031.
[3] Yan DING, Lifang WANG, Chaoran LI, Zhemin LU, Lianjie SHI. Rheumatoid arthritis combined with IgG4-related disease successfully treated with rituximab: A case report [J]. Journal of Peking University (Health Sciences), 2025, 57(6): 1203-1207.
[4] Ju YANG, Jing XU, Juhua DAI, Lianjie SHI. Expression of lumican protein in serum of patients with rheumatoid arthritis and its correlation with disease and immune activities [J]. Journal of Peking University (Health Sciences), 2025, 57(5): 911-918.
[5] Lianghua FENG, Lirong HONG, Yujia CHEN, Xueming CAI. Role and mechanism of ubiquitin-specific protease 35 in ferroptosis of rheumatoid arthritis-fibroblast like synoviocytes [J]. Journal of Peking University (Health Sciences), 2025, 57(5): 919-925.
[6] Peiwen JIA, Ying YANG, Yaowei ZOU, Zhiming OUYANG, Jianzi LIN, Jianda MA, Kuimin YANG, Lie DAI. Clinical characteristics of overlapping syndromes of low muscle mass in patients with rheumatoid arthritis and their impact on physical function [J]. Journal of Peking University (Health Sciences), 2024, 56(6): 1009-1016.
[7] Doudou MA, Zhemin LU, Qian GUO, Sha ZHU, Jin GU, Yan DING, Lianjie SHI. Successful treatment of rheumatoid arthritis complicated with myasthenia gravis with low-dose rituximab: A case report [J]. Journal of Peking University (Health Sciences), 2024, 56(6): 1110-1114.
[8] Rui YAN, Dan KE, Yan ZHANG, Li LI, Huanran SU, Wei CHEN, Mingxia SUN, Xiaomin LIU, Liang LUO. Diagnostic significance of serum chemokine CXCL-10 and Krebs von den lungen-6 level in patients with rheumatoid arthritis associated interstitial lung disease [J]. Journal of Peking University (Health Sciences), 2024, 56(6): 956-962.
[9] Liang ZHAO, Chenglong SHI, Ke MA, Jing ZHAO, Xiao WANG, Xiaoyan XING, Wanxing MO, Yirui LIAN, Chao GAO, Yuhui LI. Immunological characteristics of patients with anti-synthetase syndrome overlap with rheumatoid arthritis [J]. Journal of Peking University (Health Sciences), 2024, 56(6): 972-979.
[10] Yijun HAN, Xiaoli CHEN, Changhong LI, Jinxia ZHAO. Application status of methotrexate in patients with rheumatoid arthritis [J]. Journal of Peking University (Health Sciences), 2024, 56(6): 994-1000.
[11] Dongwu LIU, Jie CHEN, Mingli GAO, Jing YU. Rheumatoid arthritis with Castleman-like histopathology in lymph nodes: A case report [J]. Journal of Peking University (Health Sciences), 2024, 56(5): 928-931.
[12] Huina HUANG,Jing ZHAO,Xiangge ZHAO,Ziran BAI,Xia LI,Guan WANG. Regulatory effect of lactate on peripheral blood CD4+ T cell subsets in patients with rheumatoid arthritis [J]. Journal of Peking University (Health Sciences), 2024, 56(3): 519-525.
[13] Xiaofei TANG,Yonghong LI,Qiuling DING,Zhuo SUN,Yang ZHANG,Yumei WANG,Meiyi TIAN,Jian LIU. Incidence and risk factors of deep vein thrombosis in patients with rheumatoid arthritis [J]. Journal of Peking University (Health Sciences), 2024, 56(2): 279-283.
[14] Xue ZOU,Xiao-juan BAI,Li-qing ZHANG. Effectiveness of tofacitinib combined with iguratimod in the treatment of difficult-to-treat moderate-to-severe rheumatoid arthritis [J]. Journal of Peking University (Health Sciences), 2023, 55(6): 1013-1021.
[15] Qi WU,Yue-ming CAI,Juan HE,Wen-di HUANG,Qing-wen WANG. Correlation between dyslipidemia and rheumatoid arthritis associated interstitial lung disease [J]. Journal of Peking University (Health Sciences), 2023, 55(6): 982-992.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd