Distinct arthropathies of the hands in patients with anti-aminoacyl tRNA synthetase antibodies: usefulness of autoantibody profiles in classifying patients

Rheumatology (Oxford). 2014 Jun;53(6):1120-4. doi: 10.1093/rheumatology/ket453.

Abstract

Objective: The aim of this study was to characterize arthropathies of the hands associated with antiaminoacyl tRNA synthetase (ARS) autoantibodies.

Methods: Fifty-six patients with anti-ARS antibodies were selected from consecutive patients who visited Keio University Hospital between1983 and 2011, based on their joint symptoms and the availability of hand X-rays. Their clinical characteristics, anti-CCP antibodies, RF, and hand X-ray findings were retrospectively examined.

Results: Based on characteristic hand X-ray findings, the anti-ARS-positive patients with joint symptoms could largely be categorized into three groups. The predominant group (64%) was patients with no significant X-ray findings. The remaining patients with destructive changes were classified into two distinct groups. One group had mainly erosions in the PIP and MCP joints and/or ankylosis of the wrists with anti-CCP and RF, which is consistent with the features of RA. The other group showed subluxation of the thumbs and periarticular calcification that was independent of anti-CCP or RF, which is exclusively found in anti-Jo-1-positive patients.

Conclusion: Autoantibody profiles, including anti-CCP, RF and individual anti-ARS specificities, are useful in classifying anti-ARS-associated arthropathies of the hands into RA or anti-Jo-1-related disorders.

MeSH terms

  • Adult
  • Aged
  • Amino Acyl-tRNA Synthetases / immunology*
  • Ankylosis / diagnosis
  • Ankylosis / diagnostic imaging
  • Arthritis, Rheumatoid / diagnosis
  • Arthritis, Rheumatoid / diagnostic imaging
  • Autoantibodies / blood*
  • Biomarkers / blood
  • Calcinosis / diagnostic imaging
  • Diagnosis, Differential
  • Female
  • Hand Joints / diagnostic imaging*
  • Humans
  • Joint Diseases / diagnosis*
  • Joint Diseases / diagnostic imaging
  • Male
  • Middle Aged
  • Peptides, Cyclic / immunology
  • Radiography
  • Retrospective Studies
  • Rheumatoid Factor / blood
  • Wrist Joint / diagnostic imaging

Substances

  • Autoantibodies
  • Biomarkers
  • Peptides, Cyclic
  • cyclic citrullinated peptide
  • Rheumatoid Factor
  • Amino Acyl-tRNA Synthetases