Biomarkers of Chronic Uveitis in Juvenile Idiopathic Arthritis: Predictive Value of Antihistone Antibodies and Antinuclear Antibodies

被引:42
作者
Nordal, Ellen B. [1 ,2 ,3 ]
Songstad, Nils T. [1 ,3 ]
Berntson, Lillemor [4 ]
Moen, Torolf [5 ]
Straume, Bjorn [2 ]
Rygg, Marite [6 ,7 ]
机构
[1] Univ Hosp N Norway, Dept Pediat, N-9038 Tromso, Norway
[2] Univ Tromso, Inst Community Med, Tromso, Norway
[3] Univ Tromso, Inst Clin Med, Tromso, Norway
[4] Uppsala Univ, Childrens Hosp, Dept Womens & Childrens Hlth, Uppsala, Sweden
[5] St Olavs Hosp, Dept Immunol, Trondheim, Norway
[6] St Olavs Hosp, Dept Pediat, Trondheim, Norway
[7] Norwegian Univ Sci & Technol, Fac Med, Dept Lab Med, N-7034 Trondheim, Norway
关键词
JUVENILE IDIOPATHIC ARTHRITIS; ANTINUCLEAR ANTIBODIES; HISTONES; ELISA; DISEASE BIOMARKER; UVEITIS; RHEUMATOID-ARTHRITIS; CHRONIC IRIDOCYCLITIS; SCREENING GUIDELINES; FOLLOW-UP; CHILDREN; HISTONES; PREVALENCE; AUTOANTIBODIES; COMPLICATIONS; ASSOCIATIONS;
D O I
10.3899/jrheum.081318
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. To study the predictive value of antinuclear autoantibody (ANA) tests and antihistone antibodies (AHA) as risk factors for development of chronic asymptomatic uveitis of insidious onset in juvenile idiopathic arthritis (RA). Methods. ANA by indirect immunofluorescence using HEp-2 cells (IF-ANA), ELISA for ANA (E-ANA), and AHA were analyzed in sera of 100 children with recent-onset JIA and in 58 control sera. Clinical features, including age at onset, JIA subgroup, and presence Of Uveitis, were recorded in this prospective population-based cohort study. Results. E-ANA was positive in 4 of the 100 sera, and was not associated with uveitis. Chronic uveitis developed in 16 children with JIA: in 14 of 68 positive for IF-ANA : 80, and in 13 of 44 positive for AkA >= 8 U/ml. IgM/IgG AHA were found in higher proportions in children with uveitis (mean 12.4 U/ml) than in those with JIA and no uveitis (mean 6.9 U/ml) or in healthy controls (mean 4.3 U/ml). Conclusion. No association was found between E-ANA and uveitis, and most IF-ANA-positive sera were E-ANA-negative. E-ANA is not clinically relevant in this setting and should never be used to determine frequencies of eye examinations to detect new uveitis in JIA. AHA >= 8 U/ml, IF-ANA titer 320, and young age at onset of arthritis were significant predictors for development of chronic uveitis. The diagnostic value of AHA 8 U/ml as a biomarker of chronic uveitis in JIA is very similar to IF-ANA >= 80. (First Release July 1 2009; J Rheumatol 2009:36:1737-43; doi: 10.3899/jrheum.081318)
引用
收藏
页码:1737 / 1743
页数:7
相关论文
共 36 条
[1]  
Arguedas O, 1998, J RHEUMATOL, V25, P1844
[2]  
Berntson L, 2003, J RHEUMATOL, V30, P2275
[3]   Ophthalmologic examinations in children with juvenile rheumatoid arthritis [J].
Cassidy, J ;
Kivlin, J ;
Lindsley, C ;
Nocton, J .
PEDIATRICS, 2006, 117 (05) :1843-1845
[4]  
Chalom EC, 1997, J RHEUMATOL, V24, P2031
[5]  
Fawcett PT, 1999, J RHEUMATOL, V26, P1822
[6]   The eyes have it The need to improve awareness and access to early ophthalmological screening for juvenile idiopathic arthritis associated uveitis [J].
Foster, Helen ;
Ramanan, Athimalaipet V. .
RHEUMATOLOGY, 2009, 48 (04) :330-331
[7]  
Fritzler MJ, 2003, J RHEUMATOL, V30, P2374
[8]   Laboratory screening of connective tissue diseases by a new automated ENA screening assay (EliA Symphony) in clinically defined patients [J].
González, C ;
García-Berrocal, B ;
Pérez, M ;
Navajo, JA ;
Herraez, O ;
González-Buitrago, JM .
CLINICA CHIMICA ACTA, 2005, 359 (1-2) :109-114
[9]   Prevalence and complications of uveitis in juvenile idiopathic arthritis in a population-based nation-wide study in Germany: suggested modification of the current screening guidelines [J].
Heiligenhaus, A. ;
Niewerth, M. ;
Ganser, G. ;
Heinz, C. ;
Minden, K. .
RHEUMATOLOGY, 2007, 46 (06) :1015-1019
[10]  
Ingegnoli F, 2004, CLIN EXP RHEUMATOL, V22, P499