Contrast-enhanced CT and Antibodies To Mutated Citrullinated Vimentine: Clinical Utility In Early Rheumatoid Arthritis

Abstract

R heumatoid arthritis (RA) is the most common inflammatory chronic disease of the joints. It is characterized by disease activity and bone destruction resulting in joint destruction, functional impairment, and increased mortality, Early definitive diagnosis is essential in RA patients, as they have a true chance for achieving a “cure” of them disease if they are treated early and aggressively in the “window of opportunity” period. However, this needs sensitive clinical and laboratory diagnostic tools. The present study was designed to evaluate the clinical utility of contrast enhanced CT scan and antibodies to mutated citrullinated vimentin (MCV) in patients with early rheumatoid arthritis (less than one year duration). This study included 50 patients with recent onset rheumatoid arthritis (< 1 year) who satisfied the ACR diagnostic criteria and 20 apparently healthy controls. All included patients were subjected to detailed history taking with special emphasis on: age, sex, disease duration, drugs intake (steroids, NSAIDS, and DMARDS) and history of smoking. Through clinical examination including rheumatological examination, laboratory investigations including CBC, ESR, CRP titer, both kidney function tests and liver enzymes with serological detection of RF titer and anti MCV titer and lastly both plain radiography and contrast enhanced CT scan on both hands were done. In the present study the majority of rheumatoid patients were females (80%) with a female to male ratio 4: 1 , their age ranged between 18- 52 yrs, RF was positive (58%) and negative in (42%) of rheumatoid patients, anti-MCV antibodies were positive in (88%) and negative in (12%) of rheumatoid patients, while it was positive in (15%) of healthy controls.