Determination of the Subset of Sjögren’s Syndrome with Articular Manifestations by Anticyclic Citrullinated Peptide Antibodies

Objective.To investigate whether anticyclic citrullinated peptide antibodies (anti-CCP) predict the subset of Japanese patients with Sjögren’s syndrome (SS) with articular manifestations.Methods.Eighty-seven patients with SS were enrolled. Prevalence of anti-CCP antibodies, IgM rheumatoid factor, anti-Ro/SSA antibody, anti-La/SSB antibody, and serum IgG concentration and their relation to articular manifestations were examined. Articular manifestations included morning stiffness and the presence of tender or swollen joints.Results.Eighty-seven SS patients were divided into 3 groups: 14 secondary SS with nonerosive rheumatoid arthritis (RA); 47 primary SS with articular manifestations; and 26 primary SS without articular manifestations. Ten out of 14 secondary SS with nonerosive RA expressed anti-CCP. Anti-CCP was the only statistically proven marker preferentially distributed in patients with articular manifestations (the first 2 groups) compared to primary SS without such manifestations; however, its frequency was low in primary SS. No patient with primary SS without articular manifestations expressed anti-CCP.Conclusion.Anti-CCP is found in the subset of Japanese with SS with articular manifestations although most of those with anti-CCP-positive SS were classified as secondary SS with RA.