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AvaliaÃÃo clÃnico-laboratorial de pacientes com artrite reumatÃide: anÃlise comparativa do fator reumatÃide e de anticorpos anticitrulina / Evaluation clinical-laboratory of patients with rheumatoid arthritis: comparative analysis of anticitrullina the rheumatoid factor and antibodiesVilena Barros de Figueiredo 04 October 2005 (has links)
CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A artrite reumatÃide à uma doenÃa auto-imune crÃnica e inflamatÃria que evolui com graus de destruiÃÃo articular e alteraÃÃes extra-articulares podendo levar a incapacidade funcional. AlÃm da avaliaÃÃo clÃnica o diagnÃstico baseia-se na determinaÃÃo do fator reumatÃide (FR) sendo que este à tambÃm positivo em indivÃduos saudÃveis como tambÃm em outras doenÃas auto-imunes e infecciosas. Os anticorpos antipeptÃdeos citrulinados cÃclicos (anti-CCP) tem sido usados no diagnÃstico da artrite reumatÃide sendo superiores ao fator reumatÃide (FR) no diagnÃstico da artrite reumatÃide (AR) recente. O estudo teve como objetivo demonstrar a presenÃa de anticorpos anticitrulina em pacientes com o diagnÃstico de artrite reumatÃide comparando com parÃmetros clÃnicos, laboratoriais e com a avaliaÃÃo da qualidade de vida desses pacientes. Para avaliar a qualidade de vida foi aplicado o questionÃrio âHealth Assessment Questionnaire.â Foi realizado um teste por imunoturbidimetria, para a detecÃÃo de FR (Roche, Indianopolis, EUA) e ELISA para o anti-CCP (Inova , San Diego, EUA) em 69 pacientes apresentando, ao menos, 4 dos critÃrios do ColÃgio Americano de Reumatologia para a classificaÃÃo de AR e em 20 controles saudÃveis. A anÃlise estatÃstica utilizou o teste exato de Fisher e teste de Spearmann com significÃncia alcanÃada com P<0.05. Os pacientes com AR tinham entre 18-75 (mÃdia = 43.9 anos), 66 (95.7%) eram mulheres, os controles com idades variando entre 20-60 anos. O inÃcio da AR variou de 4 a 384 meses (mÃdia = 74.0 e mediana = 48.0). FR foi positivo em 48 (69.6%) pacientes e 1 (0,5%) controle. O anti-CCP foi positivo em 36 (52.2%) pacientes e em 2 (10%) controles. Foi observada uma correlaÃÃo significante dos testes FR e anti-CCP com P< 0.0001 e este estudo sugere que o anti-CCP nÃo foi superior ao FR no diagnÃstico da AR estabelecida / Rheumatoid arthritis is an inflammatory, chronic and auto-immune disease that develops in degrees of articular destruction and extra-articular changes being able to lead to functional disability. Besides clinical assessment the diagnosis is based on the determination of the rheumatoid factor being this one also positive in healthy people as well as in other infectious and auto-immune diseases. Anticyclic citrullinated peptide (anti-CCP) antibodies have been used in diagnosis of rheumaoid arthritis (RA) and seen to be superior to rheumatoid factor (RF) in early onset RA diagnosis. The target of the study is to demonstrate the presence of anticitrulline antibodies in patients with rheumatoid arthritis diagnostic comparing with laboratory, clinical parameters and with the assessment of the quality of life of these patients. The âHealth Assessment Questionnaireâ has been used to assess the quality of life. We performed an immunoturbidimetry test for detection of RF (Roche,Indianopolis, USA) and an ELISA for anti-CCP antibodies (Inova, San Diego, USA) in 69 patients presenting, at least, 4 of the American College of Rheumatology criteria for classification of RA and in 20 healthy controls. For statistical analysis we used thr Fisher exact test and the Spearmann test Significance was reached wuth P<0.05. RA patients were aged between 18-75 years (mean = 43.9 years), 66 (95.7%) of then were female, controls age ranged between 20-60 years.The period of RA onset varied from 4 to 384 months (mean = 74.0 and median = 48.0). RF was positive in 48 (69.6%) patients and in 1 (0,5%) control. The anti-CCP was positive in 36 (52.2%) patients and in 2 (10%) controls. A significant correlation of RF and anti-CCP tests was observed with P< 0,0001 and this study suggests that anti-CCP was not superior to RF in diagnosis of established RA
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