Document Detail

Does serum rheumatoid factor have an influence on the clinical picture of ankylosing spondylitis?
MedLine Citation:
PMID:  9177924     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To describe the influence of serum rheumatoid factor (RF) on the clinical and radiological picture of definite ankylosing spondylitis (AS). METHODS: In a retrospective chart review of 281 AS patients typed for RF, the clinical picture of RF positive patients (Group 1) was compared with RF negative patients (Group 2); mode of onset, disease duration, and treatment were recorded. All patients were examined to determine their clinical status; the blood cell count. HLA-B27, serum IgG, IgM, IgA, and erythrocyte sedimentation rate (ESR) were determined, and radiological studies of the entire spine, pelvis and affected peripheral joints were carried out. In patients from Group 1 the HLA-DR was also determined. RESULTS: Fifteen of 281 patients (8 men, 7 women) with AS were RF+ (1:64 to 1:1024) (5.3%) and 11 were HLA-B27+. Seven patients in Group 1 had spine involvement and chronic arthritis of the knees. Four out of these 7 were tested for DR, and none was positive; in 6, AS and rheumatoid arthritis (RA) coexisted, 2 were DR1 and 2 were DR4 (test not carried out in 2). In two others we found spinal involvement only, and one of them had both DR1 and DR4. The onset of AS was similar in both groups. Group 1 was characterized by a chronic disease of moderate intensity with chronic arthritis of the metacarpophalangeal and proximal interphalangeal joints (p = 0.0008 and p = 0.04, respectively), no valvulopathy (p = 0.04) and fewer uveitis sequelae (p = 0.007) than Group 2. The ESR (p = 0.01), IgG (p = 0.008) and IgM (p = 0.0001) were higher in Group 1 than in Group 2. CONCLUSIONS: The presence of RF in AS is associated with a chronic disease of moderate intensity with chronic peripheral arthritis and fewer extra-articular manifestations. The presence of RF, not always associated with HLA-DR, seems to affect the course of AS and does not necessarily indicate an association with RA.
F J Jimenez-Balderas; P Martinez-Osuna; J Arellano; C Lara; P Yañez-Sanchez; A Camargo-Coronel; J Fuentes; C Bravo-Gatica; A Fraga
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and experimental rheumatology     Volume:  15     ISSN:  0392-856X     ISO Abbreviation:  Clin. Exp. Rheumatol.     Publication Date:    1997 May-Jun
Date Detail:
Created Date:  1997-07-24     Completed Date:  1997-07-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8308521     Medline TA:  Clin Exp Rheumatol     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  289-93     Citation Subset:  IM    
Department of Rheumatology, Hospital de Especialidades Bernarda Sepúlveda, México.
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MeSH Terms
Finger Joint
HLA-B27 Antigen / analysis
HLA-DR Antigens / analysis
Knee Joint
Retrospective Studies
Rheumatoid Factor / blood*
Spinal Diseases / blood,  immunology,  physiopathology
Spondylitis, Ankylosing / blood*,  immunology,  physiopathology*
Reg. No./Substance:
0/HLA-B27 Antigen; 0/HLA-DR Antigens; 9009-79-4/Rheumatoid Factor

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