Abstract
The serological diagnosis of juvenile rheumatoid arthritis (JRA) is difficult, with only 7-10% of patients 19S IgM rheumatoid factor positive. About 60-70% of patients are positive for hidden 19S IgM rheumatoid factor, but this test requires serum separation and is not available in most laboratories. Antiperinuclear factor has been described in both seropositive and seronegative adult patients with rheumatoid arthritis, but has not been thoroughly evaluated in children with JRA. This study determined the diagnostic sensitivity and specificity of antiperinuclear factor in patients with JRA. Serum samples from 64 children with JRA, 24 with systemic lupus erythematosus (SLE), and 24 control subjects were tested for the presence of antiperinuclear factor. A total of 10 (83%) of seropositive, polyarticular onset and six (37%) of seronegative, polyarticular onset patients with JRA were positive for antiperinuclear factor. The occurrence of antiperinuclear factor in five (19%) with pauciarticular onset and one (10%) with systemic onset (JRA) as well as in four (17%) with SLE was not increased compared with the control subjects (1/24 (4%)). These data show an overall diagnostic sensitivity and specificity of 34 and 90% respectively in this group of patients. Although less sensitive than the hidden rheumatoid factor assay, the antiperinuclear factor assay is easier to perform and may contribute to the serological diagnosis of JRA.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Boerbooms A. M., Westgeest A. A., Reekers P., van de Putte L. B. Immunogenetic heterogeneity of seronegative rheumatoid arthritis and the antiperinuclear factor. Ann Rheum Dis. 1990 Jan;49(1):15–17. doi: 10.1136/ard.49.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cassidy J. T., Levinson J. E., Bass J. C., Baum J., Brewer E. J., Jr, Fink C. W., Hanson V., Jacobs J. C., Masi A. T., Schaller J. G. A study of classification criteria for a diagnosis of juvenile rheumatoid arthritis. Arthritis Rheum. 1986 Feb;29(2):274–281. doi: 10.1002/art.1780290216. [DOI] [PubMed] [Google Scholar]
- Janssens X., Veys E. M., Verbruggen G., Declercq L. The diagnostic significance of the antiperinuclear factor for rheumatoid arthritis. J Rheumatol. 1988 Sep;15(9):1346–1350. [PubMed] [Google Scholar]
- Johnson G. D., Carvalho A., Holborow E. J., Goddard D. H., Russell G. Antiperinuclear factor and keratin antibodies in rheumatoid arthritis. Ann Rheum Dis. 1981 Jun;40(3):263–266. doi: 10.1136/ard.40.3.263. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marmont A. M., Damasio E. E., Bertorello C., Ferdinando ROSSI Studies on the antiperinuclear factor. Arthritis Rheum. 1967 Apr;10(2):117–128. doi: 10.1002/art.1780100206. [DOI] [PubMed] [Google Scholar]
- Moore T. L., Dorner R. W., Osborn T. G., Zuckner J. Hidden 19S IgM rheumatoid factors. Semin Arthritis Rheum. 1988 Aug;18(1):72–75. doi: 10.1016/0049-0172(88)90036-4. [DOI] [PubMed] [Google Scholar]
- NIENHUIS R. L., MANDEMA E. A NEW SERUM FACTOR IN PATIENTS WITH RHEUMATOID ARTHRITIS; THE ANTIPERINUCLEAR FACTOR. Ann Rheum Dis. 1964 Jul;23:302–305. doi: 10.1136/ard.23.4.302. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sondag-Tschroots I. R., Aaij C., Smit J. W., Feltkamp T. E. The antiperinuclear factor. 1. The diagnostic significance of the antiperinuclear factor for rheumatoid arthritis. Ann Rheum Dis. 1979 Jun;38(3):248–251. doi: 10.1136/ard.38.3.248. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tan E. M., Cohen A. S., Fries J. F., Masi A. T., McShane D. J., Rothfield N. F., Schaller J. G., Talal N., Winchester R. J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271–1277. doi: 10.1002/art.1780251101. [DOI] [PubMed] [Google Scholar]
- Veys E. M., De Keyser F., De Vlam K., Verbruggen G. The antiperinuclear factor. Clin Exp Rheumatol. 1990 Sep-Oct;8(5):429–431. [PubMed] [Google Scholar]
- Westgeest A. A., Boerbooms A. M., van de Putte L. B. The influence of serum dilution on findings of antiperinuclear factor prevalence in rheumatoid arthritis. Arthritis Rheum. 1990 May;33(5):759–760. doi: 10.1002/art.1780330524. [DOI] [PubMed] [Google Scholar]
- Westgeest A. A., van Loon A. M., van der Logt J. T., van de Putte L. B., Boerbooms A. M. Antiperinuclear factor, a rheumatoid arthritis specific autoantibody: its relation to Epstein-Barr virus. J Rheumatol. 1989 May;16(5):626–630. [PubMed] [Google Scholar]
- Youinou P., Pennec Y., Le Goff P., Ferec C., Morrow W. J., Le Menn G. Antiperinuclear factor in Sjögren's syndrome in the presence or absence of rheumatoid arthritis. Clin Exp Rheumatol. 1984 Jan-Mar;2(1):5–9. [PubMed] [Google Scholar]