Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Because of low frequency of HLA-B27 (lower than 1%), the prevalence of the spondarthritis (SpA) is thought to be much lower than rheumatoid arthritis (RA) in Japanese. Therefore an evaluation of the inflammatory back pain and enthesitis is not routinely performed, and early diagnosis of the spondarthritis (SpA) is not substantially performed. We examined the presence of clinical findings to suggest SpA in each of the positive cases of the anti-cyclic citrullinated peptide antibody(ACPA) and the negative cases of ACPA in Japanese.
Methods: We randomly selected 300 cases from the patients who had musculoskeletal symptoms as chief complaint in outpatient clinic of Rheumatology, Osaka City University Hospital.We retrospectively examined frequency of clinical findings of SpA including enthesitis, dactylitis, the arthritis of axis joints and the inflammatory back pain according to clinical records in cases of ACPA positive, and ACPA negative.
Results: Among 300 cases, 95 cases showed positive of ACPA and 205 cases showed negative. In the ACPA positive cases, only two cases showed more than one enthesitis, but 88 cases showed either enthesitis (80 cases) or ductilitis (10 cases), the arthritis of axis joints (62 cases), inflammatory lumbago (2 cases) in the ACPA negative cases. The cases with findings to suggest potential of SpA are more frequently in ACPA-negative cases in Japanese. However, the patients themselves actually rarely reported these symptoms, therefore findings suggesting SpA were possibly missed unless we took physical examination adequately.
Conclusion: The Japanese SpA patients may have relatively mild symptoms and may be diagnosed seronegative RA rather than undifferentiated SpA. It is necessary to take physical examination appropriately in ACPA-negative Japanese patients even if they meet classification criteria of RA to prevent passing over SpA, moreover it is necessary to find genetic marker in Japanese such as HLA-B27 in Caucasian.
To cite this abstract in AMA style:Goto H, Hayashi N, Yamada S, Inaba M. Undifferentiated Spondylarthritis May More Frequent in Japanese [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/undifferentiated-spondylarthritis-may-more-frequent-in-japanese/. Accessed December 7, 2019.
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