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
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  • Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, China

Received date: 2020-06-12

  Online published: 2020-12-13

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.

Cite this article

Jing-feng ZHANG , Xiu-ling YE , Meng DUAN , Xiao-li ZHOU , Zhong-qiang YAO , Jin-xia ZHAO . Clinical and laboratory characteristics of rheumatoid arthritis with positive antinuclear antibody[J]. Journal of Peking University(Health Sciences), 2020 , 52(6) : 1023 -1028 . DOI: 10.19723/j.issn.1671-167X.2020.06.006

References

[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.
[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.
[3] Torre IG, Mendez LM. Studies of antinuclear antibodies in rheumatoid arthritis[J]. J Rheumatol, 1982,9(4):603-606.
[4] Aitcheson CT, Peebles C, Joslin F, et al. Characteristics of antinuclear antibodies in rheumatoid arthritis[J]. Arthritis Rheum, 1980,23(5):528-538.
[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.
[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.
[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.
[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.
[9] Bienenstock H. Rheumatoid plantar synovial cysts[J]. Ann Rheum Dis, 1975,34(1):98-99.
[10] Antero DC, Parra AGM, Miyazaki FH, et al. Secondary Sj?gren’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.
[13] Tellides G, Pober JS. Inflammatory and immune responses in the arterial media[J]. Circ Res, 2015,116(2):312-322.
[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.
[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.
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