Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation and deformity of the joints. Objectives: The study have two purposes: (1) Identify the sensitivity of anti - CCP2 antibodies in rheumatoid arthritis. (2) Identify the correlation between anti - CCP2 antibodies and clinical manifestations, laboratory features of rheumatoid arthritis. Subjects and method: The study was carried out on 70 patients with rheumatoid arthritis from March to July 2006 in rheumatology department at Bach Mai hospital. All they were diagnosed according to the criteria of American College of Rheumatology 1987. Results: Results of study showed that: (1) The sensitivity of anti - CCP2 antibodies is 67.1% (2) The sensitivity of anti - CCP2 antibodies in patients with rheumatoid arthritis is 67.1 % and is as high as the sensitivity of rheumatoid factor. In early stage of disease (the duration of disease under 12 months) the sensitivity of anti - CCP2 antibodies is higher than rheumatoid factor (70% versus 57.5%). There are no significant differences between the group having anti - CCP2 antibodies and the group who did not have anti - CCP2 anti- bodies in any stages of disease about Ritchie index, DAS - 28 index, X - rays, erythrocyte sedimentation rate in the first hour, CRP ratio. Conclusions: The sensitivity of anti - CCP2 antibodies in patients with rheumatoid arthritis is 67.1 %. There is the relation between anti - CCP2 antibodies and the severity of the inflammation and the severity of X - rays.
Arthritis ; Rheumatoid/ pathology ; epidemiology ; Antibodies/ adverse effects

OBJECTIVE: To analyse the clinical and laboratory characteristics of antinuclear antibody (ANA) positive rheumatoid arthritis (RA) patients. METHODS: The clinical and laboratory data of 428 RA cases from Department of of Rheumatology and Immunology Peking University Third Hospital from Jan 2013 to Dec 2018 were collected and used to analyse characters between ANA positive group and ANA negative group. T test was used for the quantitative data in accordance with normal distribution. Wilcoxon rank sum test was used for the quantitative data of non normal distribution. The qualitative data were analyzed by chi square test. But while 1≤theoretical frequency < 5, chi square test of corrected four grid table was used. And Fisher exact probability method was used when theoretical frequency < 1. RESULTS: The number of ANA positive group was 231 (54%). The female rate was obviously higher in ANA positive group (82.7% vs. 63.5%, χ²=20.355, P < 0.01). The rate of metatarsophalangeal joints (MTPJs) involvement was lower in ANA positive group (22.1%) than in ANA negative group (33.0) (χ²=6.414, P < 0.05). The incidence of secondary Sjögren's syndrome (sSS) was much higher in ANA positive group(19.5% vs. 4.1%, χ²=23.300, P < 0.01). The positivity of rheumatoid factor (RF), as well as the positivity of anti-cyclic citrullinated peptide(CCP) antibody was much higher in ANA positive group (77.1% vs. 53.8%, χ²=25.743, P < 0.01, 74.9% vs. 59.4%, χ²=11.694, P < 0.01, respectively). The levels of immunoglobulin G (IgG) and immunoglobulin M (IgM) of ANA positive group were higher [(15.1±5.1) g/L vs. (13.8±5.3) g/L, t=2.359, P < 0.05, 1.25 (0.92) g/L vs. 1.05 (0.65) g/L, Z=-3.449, P < 0.01, respectively]. But the levels of hemoglobin (Hb) and platelet (PLT) was lower in ANA positive group[(109.64±17.98) vs. (114.47±18.48) g/L, t=-2.734, P < 0.01; (266.4×10⁹±104.6×10⁹) vs. (295.9×10⁹±100.1×10⁹) /L, t=-2.970, P < 0.01, respectively]. CONCLUSION The incidence of sSS was obviously higher in ANA positive group than in ANA negative group. Serum IgG of ANA positive group was higher, but Hb and PLT were lower.
Antibodies, Antinuclear ; Arthritis, Rheumatoid/epidemiology* ; Autoantibodies ; Female ; Humans ; Laboratories ; Peptides, Cyclic ; Rheumatoid Factor

OBJECTIVE: To investigate the clinical characteristics and high risk factors of Rheumatoid arthritis (RA) complicated with tuberculosis infection. METHODS: Patients with rheumatoid arthritis diagnosed in the hospital of Sichuan Provincial People's Hospital from January 2007 to January 2017 was retrospectively collected, who were enrolled in the study group. A control group was randomly selected from the RA patients hospitalized in the same period without co-infection at a ratio of 1 :2. The general data, clinical data, laboratory test data, treatment plan, etc. of the two groups were collected in detail for single factor statistical analysis. Then multivariate Logistic regression was used to analyze the independent risk factors of RA complicated with tuberculosis infection with statistical significance in univariate analysis. RESULTS: The clinical manifestations of fever (83.3%) were most common, followed by cough (69%) and body mass loss (45.2%). In the infected group, pulmonary tuberculosis accounted for 73.3%. In the infected group the chest CT showed two or more cases, accounting for 59%. There were 9 cases (33.3%) occurring in the typical tuberculosis occurrence site. Compared with the control group, the erythrocyte sedimentation rate (ESR), C-reaction protein (CRP) levels, and the daily average dose of glucocorticoid in 1 year in the infected group were higher than those in the control group. And those differences were statistically significant(P < 0.05). There were no significant differences in gender, age, disease duration, disease activity score, white blood cell (WBC), platelet (PLT), hemoglobin (Hb), immunoglobulin G (IgG), complement (C), Anti cyclic citrullinated peptide antibody (anti-CCP), CD4⁺T cell count, and immunosuppressant use (P > 0.05). Multivariate Logistic regression analysis showed that CRP levels(OR=1.016, 95%CI:1.002-1.031) and the daily average dose of glucocorticoid in 1 year(OR=1.229, 95%CI:1.066-1.418)were the independent risk factors of RA complica-ted with tuberculosis infection. CONCLUSION RA patients with tuberculosis infection are mainly phthisis. The clinical manifestations of RA combined with tuberculosis infection are lack of specificity, and the chest imaging features of pulmonary tuberculosis are diverse, which are easy to be misdiagnosed. CRP levels and the daily average dose level of glucocorticoid in 1 year were risk factors for RA and tuberculosis infection.
Arthritis, Rheumatoid/complications* ; Autoantibodies ; Blood Sedimentation ; Humans ; Peptides, Cyclic ; Retrospective Studies ; Rheumatoid Factor ; Tuberculosis/epidemiology*

Juvenile rheumatoid arthritis (JRA) is basically the same disease as rheumatoid arhritis in the adult. However juvenile rheumatoid arthritis has many features that differ from rheumatoid arthritis in the adult, and since the onset of the disease occurs before the age of puberty, variable alterations in growth may occur. In this study, fifty cases of juvenile rheumatoid arthritis treated at Severance Hospital from January 1970 to December 1977 were analysed clinically and the following results were obtained. 1. By classification, the polyarticular type (46%) was most frequent, followed by the pauciarticular type (34%) and systemic type (20%) in order. 2. The most frequent joint affected was the knee (82%) followed by the ankle (60%), hand (22%), wrist (20%), etc. 3. The extra-articular manifestations on admission were high fever (40%), rash (16%), carditis (14%), lymphadenopathy (14%), etc. 4. Laboratory findings on admission showed increased ESR (88%), positive rheumatoid factor (15.5%), positive ANA (16.6%), etc. 5. Clinical symptoms were managed medically and surgically with aspirin, salicylates and steroids, physical therapy, and synovectomy.
Adolescent ; Arthritis, Juvenile Rheumatoid/classification ; Arthritis, Juvenile Rheumatoid/epidemiology* ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Human ; Korea ; Male

Asthma is traditionally regarded as a chronic airway disease, and recent literature proves its heterogeneity, based on distinctive clusters or phenotypes of asthma. In defining such asthma clusters, the nature of comorbidity among patients with asthma is poorly understood, by assuming no causal relationship between asthma and other comorbid conditions, including both communicable and noncommunicable diseases. However, emerging evidence suggests that the status of asthma significantly affects the increased susceptibility of the patient to both communicable and noncommunicable diseases. Specifically, the impact of asthma on susceptibility to noncommunicable diseases such as chronic systemic inflammatory diseases (e.g., rheumatoid arthritis), may provide an important insight into asthma as a disease with systemic inflammatory features, a conceptual understanding between asthma and asthma-related comorbidity, and the potential implications on the therapeutic and preventive interventions for patients with asthma. This review discusses the currently under-recognized clinical and immunological phenotypes of asthma; specifically, a higher risk of developing a systemic inflammatory disease such as rheumatoid arthritis and their implications, on the conceptual understanding and management of asthma. Our discussion is divided into three parts: literature summary on the relationship between asthma and the risk of rheumatoid arthritis; potential mechanisms underlying the association; and implications on asthma management and research.
Arthritis, Rheumatoid* ; Asthma* ; Comorbidity ; Epidemiology ; Genetic Heterogeneity ; Humans ; Phenotype* ; Population Characteristics*

Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease. The prevalence of RA is between 0.5~1% and annual incidence of RA is approximately 0.2~0.4/1,000 persons. The prevalence and incidence of RA appear to have fallen in the last 50 years. Risk factors for the development of RA include genetic factors, hormonal factors, reproductive factors, environmental factors and life-style factors. The currently accepted classification scheme for RA is the 1987 American Rheumatism Association (ARA) criteria. This criteria is both sensitive and specific, but it has limitation in classifying early disease.
Arthritis, Rheumatoid* ; Classification ; Diagnosis* ; Epidemiology* ; Humans ; Incidence ; Joint Diseases ; Prevalence ; Rheumatic Diseases ; Risk Factors

No abstract available.
Arthritis, Rheumatoid/*epidemiology/*immunology ; Autoantibodies/*blood ; Female ; Humans ; Male ; Peptides, Cyclic/*immunology

The purposes of this study were to test the negative association between schizophrenia and rheumatoid arthritis(RA) and to clarify the role of prolactin and estrogen as protective factors in this association. The author compared the prevalence rate of RA between 561 patients with schizophrenia and 222 patients with mood disorder. For investigating the role of estrogen and prolactin, the author checked the plasma prolactin and estradiol level in 80 patients with paranoid schizophrenia and 77 patients with RA. The results were as follows. 1) Epidemiological data The prevalence rate of RA in the schizophrenic group was 0/561 and that of RA in the mood disorder group was 2/222. To compare these results between two groups, the author applied the Binomial test using the average prevalence rate of RA(0.8%) in the general population as a reference rate. The prevalence rate of RA in the schizophrenic group was significantly lower than that of RA in the general population. However, the prevalence rate of RA in the mood disorder group was not significantly different to that of RA in the general population. 2) Comparison of plasma prolactin and estradiol level between two groups. The plasma level of prolactin in the schizophrenic group was significantly higher than that of prolactin in th RA group(p=0.000). However, the plasma level of estradiol in the schizophrenic group was significantly lower than that of estradiol in the RA group(p=0.017). These results were not consistent across gender. To contrast with the results in the female group, which were consistent with the results in the total subjects, for the male group, the plasma levels of prolactin and estradiol in the schizophrenic group were significantly higher than those of prolactin and estradiol in th RA group. These results support the results of previous studies which confirm the negative association between schizophrenia and RA. These results also suggest that the elevation of plasma prolactin level in the patient with schizophrenia has a antirheumatic effect while the elevation of plasma estradiol level in the patients with RA has a anti-schizophrenic effect, and that these effects act as a possible mechanism in the negative association between two disorders. However, these results suggest that this association is specific to female patients.
Arthritis, Rheumatoid* ; Epidemiology* ; Estradiol ; Estrogens* ; Female ; Humans ; Male ; Mood Disorders ; Plasma ; Prevalence ; Prolactin* ; Schizophrenia* ; Schizophrenia, Paranoid

Introduction of tumor necrosis factor (TNF) inhibitor for the treatment of rheumatoid arthritis (RA) induces not only significant improvement of symptoms and signs of RA but also substantial inhibition of progressive joint damage. Such therapeutic efficacies of TNF inhibitor have led to a paradigm shift in the treatment of RA. In spite of its dramatic effect against RA, it is now well established that the use of TNF inhibitor significantly increases the risk of tuberculosis in patients with RA. Therefore some countries have presented guidelines in the use of TNF inhibitors for rheumatoid arthritis to reduce the risk of tuberculosis. Korea Food and Drug Association (KFDA) have also provided guidelines for treating latent tuberculosis when using TNF inhibitors. In this article, we reviewed the general epidemiology of tuberculosis and incidence rates of tuberculosis in RA patients and those of RA patients treated with TNF inhibitors. We also introduced methods for the diagnosis of latent tuberculosis, and various guidelines published in different countries in managing tuberculosis in RA patients who were to be treated with TNF inhibitors. Finally, we suggest requirement of more appropriate guidelines for Korean RA patients who are candidates for treatment with TNF-inhibitors.
Arthritis, Rheumatoid* ; Diagnosis ; Epidemiology ; Humans ; Incidence ; Joints ; Korea ; Latent Tuberculosis ; Tuberculosis* ; Tumor Necrosis Factor-alpha*

BACKGROUND: Few studies have assessed the relationship between multimorbidity patterns and mortality risk in the Chinese population. We aimed to identify multimorbidity patterns and examined the associations of multimorbidity patterns and the number of chronic diseases with the risk of mortality among Chinese middle-aged and older adults. METHODS: We used data from the China Kadoorie Biobank and included 512,723 participants aged 30 to 79 years. Multimorbidity was defined as the presence of two or more of the 15 chronic diseases collected by self-report or physical examination at baseline. Multimorbidity patterns were identified using hierarchical cluster analysis. Cox regression was used to estimate the associations of multimorbidity patterns and the number of chronic diseases with all-cause and cause-specific mortality. RESULTS: Overall, 15.8% of participants had multimorbidity. The prevalence of multimorbidity increased with age and was higher in urban than rural participants. Four multimorbidity patterns were identified, including cardiometabolic multimorbidity (diabetes, coronary heart disease, stroke, and hypertension), respiratory multimorbidity (tuberculosis, asthma, and chronic obstructive pulmonary disease), gastrointestinal and hepatorenal multimorbidity (gallstone disease, chronic kidney disease, cirrhosis, peptic ulcer, and cancer), and mental and arthritis multimorbidity (neurasthenia, psychiatric disorder, and rheumatoid arthritis). During a median of 10.8 years of follow-up, 49,371 deaths occurred. Compared with participants without multimorbidity, cardiometabolic multimorbidity (hazard ratios [HR] = 2.20, 95% confidence intervals [CI]: 2.14 - 2.26) and respiratory multimorbidity (HR = 2.13, 95% CI:1.97 - 2.31) demonstrated relatively higher risks of mortality, followed by gastrointestinal and hepatorenal multimorbidity (HR = 1.33, 95% CI:1.22 - 1.46). The mortality risk increased by 36% (HR = 1.36, 95% CI: 1.35 - 1.37) with every additional disease. CONCLUSION Cardiometabolic multimorbidity and respiratory multimorbidity posed the highest threat on mortality risk and deserved particular attention in Chinese adults.
Aged ; Arthritis, Rheumatoid ; Asians ; China/epidemiology* ; Humans ; Hypertension ; Middle Aged ; Multimorbidity