Ravelli A, Varnier GC, Oliveira S et al. Arthritis Rheum 2011;63:267–75.
During the last 5 years, it has become clear that “seropositive rheumatoid arthritis” (meaning patients with anti-citrullinated antigen antibodies) is a different disease than “seronegative rheumatoid arthritis”. A detailed analysis of almost 1000 patients with juvenile idiopathic arthritis (JIA) indicates that antinuclear antibody (ANA)-positive JIA patients can be classified as different to ANA-negative JIA patients. It is expected that refinement of the disease classification may lead to better understanding and subsequent treatment of the respective forms of JIA.
In this study, 971 juvenile idiopathic arthritis (JIA) patients who were followed over a 22-year period were analyzed. Of these, 711 were antinuclear antibody (ANA)-positive, 149 were ANA-negative, and 111 had an indeterminate ANA status (the latter patients were excluded from the analysis). ANA-positive patients in the different International League of Associations for Rheumatology (ILAR) categories (oligoarthritis, rheumatoid factor-negative polyarthritis, psoriatic arthritis, and undifferentiated arthritis) were similar in terms of age at disease onset, female-to-male ratio, and frequency of asymmetric arthritis and iridocyclitis. The ANA-negative group was older at disease presentation than the ANA-positive group. The ANA-negative group also had a lower prevalence of females, a lower frequency of iridocyclitis and asymmetric arthritis, a greater number of affected joints over time, and a different pattern of arthritis.