scholarly journals Anti-Cyclic Citrullinated Peptide Antibody-Positive Meningoencephalitis in the Preclinical Period of Rheumatoid Arthritis

2016 ◽  
Vol 8 (2) ◽  
pp. 156-160 ◽  
Author(s):  
Tomoya Shibahara ◽  
Tomonaga Matsushita ◽  
Ryu Matsuo ◽  
Yoshihisa Fukushima ◽  
Kenji Fukuda ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Rare Complication ◽  
High Dose ◽  
Mri Findings ◽  
High Grade Fever ◽  
Cyclic Citrullinated Peptide ◽  
Fluid Attenuated Inversion Recovery ◽  
Subarachnoid Spaces ◽  
Magnetic Resonance Imaging Mri ◽  
Citrullinated Peptide

Rheumatoid meningoencephalitis (RM) is a rare complication of rheumatoid arthritis (RA). This report describes a 63-year-old man with complaints of high-grade fever, headache, and vomiting for several days before admission. Both his serum and cerebrospinal fluid were positive for anti-cyclic citrullinated peptide (CCP) antibody and rheumatoid factor, and contrast-enhanced fluid-attenuated inversion recovery magnetic resonance imaging (MRI) showed abnormal gadolinium enhancement of the meninges and high-intensity lesions in the subarachnoid spaces. The patient was diagnosed with RM despite lack of signs suggesting RA. His symptoms drastically improved with intravenous infusion of high-dose methylprednisolone. Two months later, he developed RA. The findings in this patient suggest that RM could develop prior to the onset of RA. Anti-CCP antibody and MRI findings may be useful for the diagnosis of RM, regardless of RA history.

scholarly journals Magnetic resonance findings may aid in diagnosis of protracted febrile myalgia syndrome: a retrospective, multicenter study

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Neta Aviran ◽  
Gil Amarilyo ◽  
Yaniv Lakovsky ◽  
Rotem Tal ◽  
Jenny Garkaby ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Compound Heterozygous ◽  
Mri Findings ◽  
High Grade Fever ◽  
Initial Manifestation ◽  
Mefv Mutations ◽  
M694v Mutation ◽  
Magnetic Resonance Imaging Mri

Abstract Background Protracted febrile myalgia syndrome (PFMS) is a rare complication of Familial Mediterranean fever (FMF). The diagnosis is based on clinical symptoms and is often challenging, especially when PFMS is the initial manifestation of FMF. The aim of this report was to describe the magnetic resonance imaging (MRI) findings in pediatric patients with PFMS. Results There were three girls and two boys ranging in age from 6 months to 16 years, all of Mediterranean ancestry. Three had high-grade fever, and all had elevated inflammatory markers. MRI of the extremities yielded findings suggestive of myositis, which together with the clinical picture, normal CPK levels, and supporting family history of FMF, suggested the diagnosis of PFMS. Out of most common MEFV mutations tested, one patient was homozygous for M694V mutation, three were heterozygous for M694V mutation, and one was compound heterozygous for the M694V and V726A mutations. Conclusions MRI may serve as an auxiliary diagnostic tool in PFMS.

scholarly journals AB0224 ASSOCIATIONS BETWEEN JOINT REPLACEMENT HISTORY AND CYCLIC CITRULLINATED PEPTIDE ANTIBODY TITERS IN RHEUMATOID ARTHRITIS PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1412.2-1412
Author(s):  
M. Sato ◽  
M. Takemura
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Replacement ◽  
Disease Duration ◽  
Certolizumab Pegol ◽  
Biologic Agent ◽  
Cyclic Citrullinated Peptide ◽  
Replacement Procedure ◽  
Antibody Titers ◽  
Age Range ◽  
Citrullinated Peptide

Background:High titers of cyclic citrullinated peptide antibodies (anti-CCP) are predictive of poor prognosis in the treatment of rheumatoid arthritis (RA). The 2010 ACR/EULAR classification criteria for early RA assign a high point value to cases having highly positive anti-CCP titers. Previous reports have claimed that osteoarthritic damage is more severe and advanced in RA patients who test positive for anti-CCP than in their negative counterparts.Objectives:To retrospectively investigate whether anti-CCP titers were associated with the extent of osteoarthritic damage in RA patients treated at our institution.Methods:Data were analyzed for 422 RA patients who received biologic agents due to resistance to methotrexate or other conventional antirheumatic drugs. Associations were explored between joint replacement history-i.e. total knee replacement (TKR), total hip replacement (THR), or lack thereof—and anti-CCP positivity rates and titers.Results:The sample consisted of 90 men and 332 women. On average, patients were put on biologics at 58.6 years of age (range: 22–85), and had a disease duration of 9.3 years. The first biologic agent chosen was infliximab (IFX) in 154 cases, etanercept (ETN) in 76, adalimumab (ADA) in 61, tocilizumab (TCZ) in 70, abatacept (ABT) in 41, golimumab (GLM) in 18, and certolizumab pegol (CZP) in 2. In total, 331/422 patients (78.4%) tested positive for anti-CCP. TKR was performed in 46 cases (M:F ratio: 7:39, mean age: 64.7 y, mean disease duration: 15.1 y), of which 46 were positive for anti-CCP (100%). THR was performed in 18 cases (M:F ratio: 2:16, mean age: 62.3 y, mean disease duration: 18.5 y), of which 17 were positive for anti-CCP (94.4%). The mean anti-CCP titer among all positive patients (n=331) was 152.9 IU/ml. This value was significantly higher in patients who underwent either joint replacement procedure than those who did not (215.4 v. 142.8 IU/ml, p<0.0005).Conclusion:With one exception, all RA patients who underwent joint replacement were positive for anti-CCP, and their titers were higher than non-surgical cases. Practitioners should be aware of this trend, and pay attention to the progression of damage in the knee and hip joints when treating RA patients with high anti-CCP titers.Disclosure of Interests:None declared

A comparative study of IgG second- and third-generation anti-cyclic citrullinated peptide (CCP) ELISAs and their combination with IgA third-generation CCP ELISA for the diagnosis of rheumatoid arthritis

2008 ◽  
Vol 28 (2) ◽  
pp. 153-158 ◽  
Author(s):  
Lisiane Maria Enriconi dos Anjos ◽  
Ivanio Alves Pereira ◽  
Eleonora d ‘Orsi ◽  
Andrea Piette Seaman ◽  
Rufus Watson Burlingame ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Comparative Study ◽  
Third Generation ◽  
Cyclic Citrullinated Peptide ◽  
Citrullinated Peptide
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