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P64 Prevalence and clinical significance of anti-cyclic citrullinated peptide antibodies in juvenile idiopathic arthritis
Abstracts of papers presented in IRACON-2006
Posters
169
P64
Prevalence and clinical significance of anti-cyclic citrullinated peptide antibodies in juvenile idiopathic arthritis B Vaidya, V Arya, S Gupta, SK Kabra, R Lodha, PJ Chandrasenan, R Gupta Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Objective: To study the prevalence of anti-cyclic citrullinated peptide (CCP) antibodies in Indian patients with juvenile idiopathic arthritis (JIA) and to correlate with JIA subtypes. Methods: Cross sectional study. Seventy-eight patients of JIA from rheumatology and paediatrics OPD were included in the study. The clinical profile including age of onset, duration of disease, disease activity, presence of erosion, extra-articular manifestations were recorded. Patient’s serological results RF and ANA were also noted. Anti-CCP antibodies (IgG) were tested in all these patients’ sera using the commercially available ELISA Kit (Euroimmu). More than 5 RU/ml is considered positive according to the manufacturer recommendation. Results: Anti-CCP antibodies were positive in 18/78 patients (23%) in our cohort. Anti-CCP antibodies were positive in only 2 of 34 (5.9%) patients with pauciarticular JIA and 3 of 17 (17.6%) patients with systemic onset of JIA, whereas it was positive in 13 of 27 (48.1%) polyarticular JIA patients (P < 0.001). Among patients with seropositive polyarticular JIA (RF-IgM positive) patients had higher rate of anti-CCP antibodies positivity with 7 of 8 patients (87.5%) (P < 0.001). Similarly, patients with erosions (11/19; P < 0.001) and deformities (5/10; P < 0.001) were found to have significant association with anti-CCP antibody positivity. No positive correlation was found with uveitis, ANA and disease activity. Conclusions: Anti-CCP antibodies could be detected more frequently in the sera of JIA patients with severe manifestations like erosions and deformity. It was also more significantly associated with seropositive polyarticular JIA than the other types. It can be presumed from these results that anti-CCP antibodies can be used as a marker to predict the severe course of JIA at the onset to guide optimal aggressive therapy.
P65
Evaluation of bone health in “healthy” young indian women S Ramteke, R Samant, A Bhalerao PD Hinduja National Hospital & Medical Research Centre, VS Marg, Mahim, Mumbai.
Objective: To establish bone health in “healthy” young Indian women. Methods: Inclusion criteria: nulliparous female > 25 – < 30 years of age. Dietary history, sunlight exposure and BMI were evaluated. Investigation: haemogram, serum Ca, P, alkaline PO4, serum albumin 25 (OH). D3, PTH. BMD by DEXA scan. Criteria for doing BMD: (1) normal vit. D (first 20 patients), (2) normal PTH irrespective of vit. D (in latter 41 patients) and (3) other investigations being normal. Results: sixty-one females were studied. All were working women from middle/ higher income group. Average BMI 20.2, Ca intake < 1000 mg in 73.9%, sunlight exposure: nil in 32.6%, rare in 26.08%, daily in 32.6% and 1–2 days per week in 8.69%. vit. D (61 patients): < 10 in 75.4%, 10–20 in 21.2%, between 20 and 40 in 3.27% (normal range 9.9–41) PTH (43 patients): high PTH in 53–48%, normal PTH in 46.52%, low vit. D with PTH in 44.4%, low vit. D with normal PTH in 24.19%, normal vit. D with ± PTH in 9.3%, normal vit. D normal PTH in 20.9%.DEXA scan (11/61) with normal Vit. D/PTH: 63.36%—normal BMI and 36.36—osteopenia. Conclusions: A staggering 75.4% of study subjects had very low vit. D levels of which 53.8% had high PTH levels. Even in subjects with normal PTH, osteopenia was seen in 36.36% suggesting genetic factors and low BMI, lack of exercise as contributors. Routine need for supplementation of diet with vit. D from childhood seems warranted based on this study.
P66
Frequency of anticardiolipin antibodies in suspected antiphospholipid antibody syndrome N Vasanthy, G Jayalakshmi, RC Panchapakesa, R Ravichandran, RS Rukmangatha, P Kanakarani, S Rajeswari Department of Rheumatology, Madras Medical College, Chennai, Tamil Nadu.
Objectives: To study the frequency of anticardiolipin antibodies in suspected APS patients. Methods: About 160 (110 M : 50 F) consecutive patients suspected to have APS attending rheumatology department, Government General Hospital during the period between April 2005 and March 2006 and 20 healthy controls were included in the study. Clinical, haematological, biochemical and immunological evaluations were made. ACL IgG and IgM antibody ELISA were carried out. Results: Mean age of the patients was 30. Patients with young stroke (34), recurrent foetal loss (33), peripheral thromboembolic events (16), young myocardial infarct (7), miscellaneous (7) were included under suspected primary APS. SLE (24), Vasculitis (24), ITP (3) and 9 patients with
Posters
169
P64
Prevalence and clinical significance of anti-cyclic citrullinated peptide antibodies in juvenile idiopathic arthritis B Vaidya, V Arya, S Gupta, SK Kabra, R Lodha, PJ Chandrasenan, R Gupta Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Objective: To study the prevalence of anti-cyclic citrullinated peptide (CCP) antibodies in Indian patients with juvenile idiopathic arthritis (JIA) and to correlate with JIA subtypes. Methods: Cross sectional study. Seventy-eight patients of JIA from rheumatology and paediatrics OPD were included in the study. The clinical profile including age of onset, duration of disease, disease activity, presence of erosion, extra-articular manifestations were recorded. Patient’s serological results RF and ANA were also noted. Anti-CCP antibodies (IgG) were tested in all these patients’ sera using the commercially available ELISA Kit (Euroimmu). More than 5 RU/ml is considered positive according to the manufacturer recommendation. Results: Anti-CCP antibodies were positive in 18/78 patients (23%) in our cohort. Anti-CCP antibodies were positive in only 2 of 34 (5.9%) patients with pauciarticular JIA and 3 of 17 (17.6%) patients with systemic onset of JIA, whereas it was positive in 13 of 27 (48.1%) polyarticular JIA patients (P < 0.001). Among patients with seropositive polyarticular JIA (RF-IgM positive) patients had higher rate of anti-CCP antibodies positivity with 7 of 8 patients (87.5%) (P < 0.001). Similarly, patients with erosions (11/19; P < 0.001) and deformities (5/10; P < 0.001) were found to have significant association with anti-CCP antibody positivity. No positive correlation was found with uveitis, ANA and disease activity. Conclusions: Anti-CCP antibodies could be detected more frequently in the sera of JIA patients with severe manifestations like erosions and deformity. It was also more significantly associated with seropositive polyarticular JIA than the other types. It can be presumed from these results that anti-CCP antibodies can be used as a marker to predict the severe course of JIA at the onset to guide optimal aggressive therapy.
P65
Evaluation of bone health in “healthy” young indian women S Ramteke, R Samant, A Bhalerao PD Hinduja National Hospital & Medical Research Centre, VS Marg, Mahim, Mumbai.
Objective: To establish bone health in “healthy” young Indian women. Methods: Inclusion criteria: nulliparous female > 25 – < 30 years of age. Dietary history, sunlight exposure and BMI were evaluated. Investigation: haemogram, serum Ca, P, alkaline PO4, serum albumin 25 (OH). D3, PTH. BMD by DEXA scan. Criteria for doing BMD: (1) normal vit. D (first 20 patients), (2) normal PTH irrespective of vit. D (in latter 41 patients) and (3) other investigations being normal. Results: sixty-one females were studied. All were working women from middle/ higher income group. Average BMI 20.2, Ca intake < 1000 mg in 73.9%, sunlight exposure: nil in 32.6%, rare in 26.08%, daily in 32.6% and 1–2 days per week in 8.69%. vit. D (61 patients): < 10 in 75.4%, 10–20 in 21.2%, between 20 and 40 in 3.27% (normal range 9.9–41) PTH (43 patients): high PTH in 53–48%, normal PTH in 46.52%, low vit. D with PTH in 44.4%, low vit. D with normal PTH in 24.19%, normal vit. D with ± PTH in 9.3%, normal vit. D normal PTH in 20.9%.DEXA scan (11/61) with normal Vit. D/PTH: 63.36%—normal BMI and 36.36—osteopenia. Conclusions: A staggering 75.4% of study subjects had very low vit. D levels of which 53.8% had high PTH levels. Even in subjects with normal PTH, osteopenia was seen in 36.36% suggesting genetic factors and low BMI, lack of exercise as contributors. Routine need for supplementation of diet with vit. D from childhood seems warranted based on this study.
P66
Frequency of anticardiolipin antibodies in suspected antiphospholipid antibody syndrome N Vasanthy, G Jayalakshmi, RC Panchapakesa, R Ravichandran, RS Rukmangatha, P Kanakarani, S Rajeswari Department of Rheumatology, Madras Medical College, Chennai, Tamil Nadu.
Objectives: To study the frequency of anticardiolipin antibodies in suspected APS patients. Methods: About 160 (110 M : 50 F) consecutive patients suspected to have APS attending rheumatology department, Government General Hospital during the period between April 2005 and March 2006 and 20 healthy controls were included in the study. Clinical, haematological, biochemical and immunological evaluations were made. ACL IgG and IgM antibody ELISA were carried out. Results: Mean age of the patients was 30. Patients with young stroke (34), recurrent foetal loss (33), peripheral thromboembolic events (16), young myocardial infarct (7), miscellaneous (7) were included under suspected primary APS. SLE (24), Vasculitis (24), ITP (3) and 9 patients with