PMID- 11269531
OWN - NLM
STAT- MEDLINE
DCOM- 20010517
LR  - 20191025
IS  - 0172-8172 (Print)
IS  - 0172-8172 (Linking)
VI  - 20
IP  - 2
DP  - 2001 Feb
TI  - Clinical significance of low titer anti-nuclear antibodies in early rheumatoid 
      arthritis: implications on the presentation and long-term course of the disease.
PG  - 43-7
AB  - The objective of this study was to evaluate the clinical significance of 
      anti-nuclear antibodies (ANA) detected in the early stages of rheumatoid 
      arthritis (RA), by a retrospective comparison of the clinical, laboratory, and 
      therapeutic characteristics of patients with or without ANA. The files of 99 
      longstanding seropositive RA patients were reviewed. Data relating to 
      demographics, medical history, family history, physical findings, extra-articular 
      complications, laboratory tests, drugs [dosage, duration. efficacy, combinations, 
      adverse effects (AEs)], intra-articular injections, and surgery were recorded. 
      Patients with or without ANA at presentation of their disease were compared using 
      chi-square and t-tests. Fifty-two ANA positive (group 1) and 47 ANA negative 
      (group 2) patients were enrolled in the study. All were comparable in terms of 
      their mean age, age at diagnosis, follow-up duration (approximately 10.5 years), 
      and male:female (M:F) ratio. On admission, pain complaints were more pronounced 
      in group 1 (P = 0.004 in the feet), but the physical findings did not differ. 
      Deformities and nodules developed in similar numbers. Extra-articular 
      complications were evenly distributed; vasculitis, however, was significantly 
      more prevalent in ANA positive (10/52) than in ANA negative (2/47) patients. 
      Thyroid disease was more common in group 2 (10/47 vs 3/52). Laboratory tests 
      (presentation and maximal values) were similar, with the exception of higher 
      anti-DNA (but within normal ranges) and gamma-globulin% in group 1. Group 1 used 
      more drugs prior to diagnosis. Corticosteroids and disease-modifying 
      anti-rheumatic drugs (DMARDs) were evenly used. Combination therapy, joint 
      injections, and surgery were more prevalent in group 2. AEs to various DMARDs 
      were more common in group 1. Although similar in many aspects, RA patients with 
      ANA tend to present with more pain complaints, a higher risk of vasculitis and 
      AEs relating to use of DMARDs, while those without ANA needed more aggressive 
      therapeutic modalities.
FAU - Caspi, D
AU  - Caspi D
AD  - Department of Rheumatology, Tel Aviv (Sourasky) Medical Center, Israel.
FAU - Elkayam, O
AU  - Elkayam O
FAU - Eisinger, M
AU  - Eisinger M
FAU - Vardinon, N
AU  - Vardinon N
FAU - Yaron, M
AU  - Yaron M
FAU - Burke, M
AU  - Burke M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Germany
TA  - Rheumatol Int
JT  - Rheumatology international
JID - 8206885
RN  - 0 (Antibodies, Antinuclear)
RN  - 0 (Antirheumatic Agents)
SB  - IM
MH  - Antibodies, Antinuclear/*blood
MH  - Antirheumatic Agents/adverse effects
MH  - Arthritis, Rheumatoid/*immunology/physiopathology/therapy
MH  - Clinical Chemistry Tests
MH  - Female
MH  - Hematologic Tests
MH  - Humans
MH  - Joints/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Pain/physiopathology
MH  - Retrospective Studies
MH  - Rheumatoid Nodule/etiology
MH  - Thyroid Diseases/etiology
MH  - Treatment Outcome
MH  - Vasculitis/etiology
EDAT- 2001/03/28 10:00
MHDA- 2001/05/18 10:01
CRDT- 2001/03/28 10:00
PHST- 2001/03/28 10:00 [pubmed]
PHST- 2001/05/18 10:01 [medline]
PHST- 2001/03/28 10:00 [entrez]
AID - 10.1007/s002960000073 [doi]
PST - ppublish
SO  - Rheumatol Int. 2001 Feb;20(2):43-7. doi: 10.1007/s002960000073.