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Rheumatology Advance Access originally published online on April 22, 2009
Rheumatology 2009 48(6):676-679; doi:10.1093/rheumatology/kep065
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Anti-cyclic citrullinated peptide and anti-keratin antibodies in patients with idiopathic inflammatory myopathy

Moisés Labrador-Horrillo1, Mª Angeles Martinez2, Albert Selva-O’Callaghan1, Juan Francisco Delgado2, Xavier Martínez-Gómez3, Ernesto Trallero-Araguás1, Jose Luis Rodriguez-Sanchez2 and Miquel Vilardell-Tarrés1

1Internal Medicine Department, Vall d'Hebron General Hospital, 2Immunology Department, Hospital de la Santa Creu i Sant Pau and 3Preventive Medicine and Epidemiology Department, Vall d'Hebron General Hospital, Universitat Autonòma de Barcelona, Barcelona, Spain.

Correspondence to: Moisés Labrador-Horrillo, Vall d’Hebron General Hospital, Paseo Vall d’Hebron 119–129, 08035 Barcelona, Spain. E-mail: mlabrador{at}vhebron.net


  Abstract

Objective. To investigate the prevalence of anti-cyclic citrullinated peptide (anti-CCP) and anti-keratin antibodies (AKAs) in a cohort of patients with idiopathic inflammatory myopathy.

Methods. In a cross-sectional study, we determined the presence of anti-CCP and AKAs by ELISA and IIF, respectively, in a cohort of 90 consecutive patients with idiopathic inflammatory myopathy. Associations between anti-CCP and clinical manifestations or other autoantibodies were determined with the chi-square and Mann–Whitney U-tests. Radiographs of hands were retrospectively evaluated. Serum autoantibody profile was determined in all patients.

Results. Twelve patients were positive to anti-CCP (13.3%); in eight cases values were moderate–high. AKAs were not detected in any patient. Comparison between patients positive and negative to anti-CCP did not show clinical or biological differences. Arthritis joint erosions or positive status to anti-synthetase antibodies were not more frequent in patients with anti-CCP antibodies. Prevalence of RF was the only variable significantly associated with the presence of these antibodies (P = 0.043).

Conclusions. High titres of anti-CCP can occasionally be found in patients with inflammatory myopathy. Therefore, a possible diagnosis of RA should be considered with caution in these patients.

KEY WORDS: Anti-cyclic citrullinated peptide, Anti-keratin antibodies, Idiopathic inflammatory myopathy, Polymyositis, Inclusion body myositis, Arthritis, Myositis-specific antibodies, Autoimmunty, Rheumatoid arthritis, Rheumatoid factor

Submitted 28 October 2008; revised version accepted 26 February 2009.
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