Anti-Citrullinated Protein Antibodies and Rheumatoid Factor In First-Degree Relatives Of Rheumatoid Arthritis Patients

Abstract

Rheumatoid arthritis (RA) is the most prevalent inflammatory chronic systemic disease characterized by extensive synovitis and an autoimmune response leading to cartilage and bone erosions with consequent joint destruction (Valesini et al., 2015). ACPA present in sera and/or plasma years before disease onset, have been associated with the development of RA and with a higher diagnostic specificity for RA than RF (Majka et al., 2008). The purpose of this study is to deter¬mine the prevalence of ACPA and RF in the First-Degree Relatives of RA patients and correlate their levels with the prevalence of joint symptoms. One hundred and twenty subjects divided in two groups (83 adults and 37 pediatrics), in addition to 40 subjects divided also into another two groups (20 adults and 20 pediatrics) serving as control group were included in this study. These groups are divided as follows: • Subgroup 1 (AR): These are apparently normal adult relatives of Rheumatoid Arthritis patients. They were all sons and daughters of these RA patients. They are 44 females (53%) and 39 males (47%). Their mean ± SD age ranged from 21 to 64 years. • Subgroup 2 (PR): These are apparently normal pediatric relatives of Rheumatoid Arthritis patients. They were all sons and daughters of these RA patients. They were 14 females (37.8%) and 23 males (62.2%). Their mean ± SD age ranged from 4 to 16 years. • Subgroup 3 (AC): These are normal subjects with no family history of any rheumatologic disorders. They were 9 females (45.0%) and 11males (55.0%).Their mean ± SD age ranged from 21 to 43 years. • Subgroup 4 (PC): These are normal subjects with no family history of any rheumatologic disorders. They were 11 females (55.0%) and 9 males (45.0%). Their mean ± SD age ranged from 4 to 16 years. All subjects were subjected to full clinical history of any musculoskeletal symptoms, complete musculoskeletal examination and laboratory investigations including CBC, ESR, CRP titre, liver enzymes (AST and ALT), Anti-CCP and RF. On comparing adult relatives group and adult control group there was statistically significant increasein joint tenderness in adult relatives. Also there were statistically significant differences as regard ACPA and RF. There were significant positive correlations between ACPA and each of age, ESRandCRP. Also there weresignificant positive correlationsbetween RF and age.