A Preliminary Study for Applying Antiperinuclear Antibody Test to 2010 ACR/EULAR Classification Criteria for Rheumatoid Arthritis

Jong-Moon Choi; Think-You Kim

doi:10.3343/lmo.2013.3.1.29

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Choi and Kim: A Preliminary Study for Applying Antiperinuclear Antibody Test to 2010 ACR/EULAR Classification Criteria for Rheumatoid Arthritis

Original Article

Diagnostic Immunology

Laboratory Medicine Online

Laboratory Medicine Online 2013; 3(1): 29-33.

Published online: 1 January 2013

DOI: https://doi.org/10.3343/lmo.2013.3.1.29

A Preliminary Study for Applying Antiperinuclear Antibody Test to 2010 ACR/EULAR Classification Criteria for Rheumatoid Arthritis

Jong-Moon Choi, M.D.¹, Think-You Kim, M.D.^1,²

¹Department of Laboratory Medicine, Hanyang University Medical Center, Seoul, Korea.

²Department of Early Arthritis, Hanyang University Medical Center, Seoul, Korea.

Corresponding author: Think-You Kim, M.D. Department of Early Arthritis and Laboratory Medicine, Hanyang University Medical Center, 222 Wangsimri-ro, Seongdong-gu, Seoul 133-792, Korea. Tel: +82-2-2290-8975, Fax: +82-2-2298-1735, tykim@hanyang.ac.kr

Received 27 September 2012 Revised 8 October 2012 Accepted 8 October 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

The American College of Rheumatology/European League against Rheumatism classification criteria for rheumatoid arthritis (ACR/EULAR criteria) include the rheumatoid factor (RF) test and the anti-citrullinated peptide/protein antibody (ACPA) test as serologic makers for rheumatoid arthritis. Antiperinuclear factor (APF) test, an originator of ACPA, is highly specific for rheumatoid arthritis and can be detected in RF or anti-cyclic citrullinated peptide (anti-CCP) negative rheumatoid arthritis, but it is not included in the serologic criterion of ACR/EULAR criteria. In this study, we investigated the way for applying the APF test to ACR/EULAR criteria.

Methods

We analyzed clinical symptoms and laboratory findings of 53 patients who were suspected having rheumatoid arthritis. All patients were negative for the RF and anti-CCP and positive for APF. We classified these patients into 4 groups according to the fluorescence intensity of APF test, and gave 1-4 points for APF positivity. The proportion of patients who scored 6 or greater in ACR/EULAR criteria in relation to APF scores was evaluated.

Results

Median scores of ACR/EULAR criteria showed a tendency to increase as the level of fluorescence intensity of APF rises, but ACR/EULAR scores of 4 groups were not different significantly from each other (P>0.05). The proportion of patients who scored 6 or greater in ACR/EULAR criteria were 39.6% and 77.4%, when scores of APF positivity were 2 and 3 points, respectively.

Conclusions

We think it is reasonable to include APF test in the ACPA of ACR/EULAR criteria and give 3 points for APF positivity, regardless of its fluorescence intensity.

Keywords: Antiperinuclear factor, Rheumatoid arthritis, 2010 ACR/EULAR criteria

Figures and Tables

Table 1

Median values of CRP, ESR, number of joint involvement and score of ACR/EULAR criteria according to the fluorescence intensity of APF test

Abbreviations: CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; ACR/EULAR criteria, American College of Rheumatology/European League against Rheumatism classification criteria for rheumatoid arthritis; APF, antiperinuclear factor; NS, not significant.

Table 2

ACR/EULAR criteria scores and modified scores of 53 patients according to level of the fluorescence intensity of APF test

^*Give 1 point for the positivity of APF test in ACR/EULAR criteria. ^†Give 2 points for the positivity of APF test in ACR/EULAR criteria. ^‡Give 3 points for the positivity of APF test in ACR/EULAR criteria. ^§Give 4 points for the positivity of APF test in ACR/EULAR criteria.

Abbreviations: ACR/EULAR criteria, American College of Rheumatology/European League against Rheumatism classification criteria for rheumatoid arthritis; APF, antiperinuclear factor.

Table 3

Prevalence of patients who were scored 6 or greater when APF tests were applied in ACR/EULAR criteria system

Abbreviations: APF, antiperinuclear factor; ACR/EULAR criteria, American College of Rheumatology/European League against Rheumatism classification criteria for rheumatoid arthritis; FI, fluorescence intensity.

Notes

This article is available from http://www.labmedonline.org

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