Palindromic Rheumatism plus Positive Anti-Citrulinated Protein Antibodies Do Not Necessarily lead to Rheumatoid Arthritis

S. Cabrera and colleagues looked at patients with palindromic rheumatism with positive anti-citrullinated protein antibodies (ACPA) and were interested in the long term conversion to rheumatoid arthritis. The authors included 71 patients with palindromic rheumatism (mean follow-up of 90.9 month). 16 patients (22%) developed rheumatoid arthritis, 4 patients (5.6%) systemic lupus (SLE), and 4 patients (5.6%) other rheumatic diseases. Development of rheumatoid arthritis was more frequent in ACPA positive than in ACPA negative patients (only a trend, the difference was not statistically significant). No evidence of any rheumatic disease was observed in 26 out of the 37 ACPA positive patients (70.3%). No difference in ACPA serum levels was found in patients, who developed rheumatoid arthritis, or those, who didn’t. A significant proportion of patients with palindromic rheumatism and even with high serum titres of ACPA do not necessarily lead to rheumatoid arthritis.

[MON] 1205
A Significant Proporcion of Patients with Palindromic Rheumatism and Positive Anti-Citrulinated Protein Antibodies Do Not evolve to Rheumatoid Arthritis after a Long Term Follow-up.
S. Cabrera1, J. A. Gomez-Puerta1, M. V. Hernandez1, V. Ruiz-Esquide1, Georgina Salvador2, M.E. Gomez-Caballero1, J. Ramirez1, J. D. Can˜ete1 and R. Sanmarti1.
1Hospital Clinic of Barcelona, Barcelona, Spain, 2Hospital Mutua de Terrassa. Barcelona, Barcelona, SpainConclusion: ACPA are frequently found in the sera of PR patients and may be considered as a biomarker for RA in these patients. However, a significant proportion of patients with PR and serum positive ACPA, even those with high titers, do not develop RA after a long term follow-up.