Rheumatoid

  1. Do anti-CCP-antibodies occur in children?

    This is what we found in the literature

    Rheumatoid Arthritis in children is an own disease and is called "juvenile rheumatoid arthritis"(JRA). Often the name "juvenile idiopathic arthritis"(JIA) is used for the same clinical picture.

    Anti-CCP antibodies can be detected in some rare cases of JIA/JRA but almost exclusively in the subset of children with polyarticular disease and positive IgM rheumatoid factor.

    These are the findings in different studies:

    Authors
     

    CCP in JIA/JRA

    Comment

    Source

    Avcin T et al

    2/109

     

    Ann.Rheum.Dis. 2002; 61(7):608-611

    Brunner J et al

    2/45

    Both polyarticular and RF+

    Clin.Exp.Rheumatol. 2006; 24 (4):449-451

    Ferucci ED

    13/230

    10/77 patients with polyarticular RF+, 3 of 139 pauciarticular

    Arthritis Rheum. 2005; 52(1):239-246

    Hromadnikova I et al

    7/140

    "no additional value of anti-CCP"

    Autoimmunity 2002; 35 (6):397-401

    Kasapcopur O et al

    3/122

     

    Ann.Rheum.Dis. 2004; 63 (12):1687-1689

    Lee DM, Schur PH

    6/21

    Some of the JRA patients were adults (up to 31 yrs) with early onset

    Ann.Rheum.Dis. 2003; 62:870-874

    Syed RH et al

     17/72

     

    Ann.Rheum.Dis. 2008; 67 (7):1049-1051

    Van Rossum M et al

    10/71

    8 of 10 had polyarticular disease and were RF pos

    J.Rheumatol. 2003; 30 (4):825-828

      
      For the pdf's of the articles, please ask per e-mail.

  2. What do you know about antibodies to collagen type II?

    Collagens are components of the extracellular matrix. Collagen type II is the major collagen in articular cartilage.

    The value of the antibody determination is limited: the prevalence of anti-collagen-antibodies is relativeley low in RA-sera and they are not uncommonly found in many other diseases. Thus, specificity and sensitivity of type II anti-collagen antibodies for RA are low.

    Neither the occurrence of serum autoantibodies to native nor denatured type II collagen is specific for RA, but synovial fluids of RA patients, compared to controls, contain anti-collagen antibodies in higher frequencies and amounts. Probably, the determination of anti-collagen antibodies in synovial fluid is of greater value than in serum.

    Whenever antibodies to collagen are found, immunological cross-reactivities with C1q and fibronectin have to be taken into account.

    Since type II collagen is the predominant cartilage collagen and since type II collagen can induce an experimental arthritis in mice and rats, autoimmunity to type II collagen is of special interest in RA. However, their determination is curently more important for scientific than for diagnostic purposes.

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.