TY - JOUR T1 - Anti-Citrullinated Protein Antibody Response Associated with Synovial Immune Deposits in a Patient with Suspected Early Rheumatoid Arthritis JF - The Journal of Rheumatology JO - J Rheumatol SP - 2282 LP - 2284 DO - 10.3899/jrheum.080424 VL - 35 IS - 11 AU - ANNEMIEK WILLEMZE AU - HANI EL-GABALAWY AU - ANDREEA IOAN-FACSINAY Y1 - 2008/11/01 UR - http://www.jrheum.org/content/35/11/2282.abstract N2 - To the Editor: Anti-citrullinated protein antibodies (ACPA) are highly specific for rheumatoid arthritis (RA) and precede the onset of clinical symptoms by several years, with increasing titers as patients approach disease onset1,2. The synovium is the primary site of pathology in RA, and ACPA are readily detectable in the synovial fluid and tissue of patients with RA3. The transition from asymptomatic autoimmunity to clinically detectable synovitis is not well understood. We describe the serological and synovial features of a young woman from a multi-case RA family who initially had asymptomatic autoimmunity, then subsequently developed clinical features suggestive of early RA... ER -