RT Journal Article
SR Electronic
T1 Primary Biliary Cirrhosis (PBC), PBC Autoantibodies, and Hepatic Parameter Abnormalities in a Large Population of Systemic Sclerosis Patients
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 2250
OP 2256
DO 10.3899/jrheum.090340
VO 36
IS 10
A1 SHERVIN ASSASSI
A1 MARVIN J. FRITZLER
A1 FRANK C. ARNETT
A1 GARY L. NORMAN
A1 KAIRAV R. SHAH
A1 PRAVITT GOURH
A1 NEIL MANEK
A1 MARILYN PERRY
A1 DEVI GANESH
A1 MOHAMMAD H. RAHBAR
A1 MAUREEN D. MAYES
YR 2009
UL http://www.jrheum.org/content/36/10/2250.abstract
AB Objective. To investigate the diagnostic accuracy of antimitochondrial antibodies (AMA), sp100, and gp210 antibodies for primary biliary cirrhosis (PBC) in a large population of patients with systemic sclerosis (SSc); to examine concordance of these antibodies with subsets of SSc. Further, to assess the association of SSc-related antibodies with hepatic parameter abnormalities. Methods. We obtained medical records to verify the diagnoses of SSc and PBC. Sera from all participants were examined for the presence of SSc- and PBC-related antibodies, as well as for abnormalities in hepatic parameters. Results. We examined 817 patients with SSc, of whom 16 (2%) had confirmed PBC. The sensitivity and specificity of AMA by a MIT3 ELISA for PBC were 81.3% and 94.6%, respectively. Sp100 had a sensitivity and specificity of 31.3% and 97.4%, respectively, while gp210 had an even lower sensitivity. We were able to detect all PBC cases using AMA(MIT3) and sp100 as a combined marker, resulting in a significantly improved sensitivity of 100% (p = 0.042) with an incremental decrease in specificity to 92.6%. Independent of AMA or sp100 status, there was an association of anticentromere B (CENP-B) and anti-topoisomerase antibodies (ATA) with higher alkaline phosphatase levels (p = 0.051 and p = 0.003, respectively) while anti-RNA polymerase III (anti-RNAP) was associated with lower alkaline phosphatase levels (p = 0.019) among the patients with SSc. Conclusion. Utilization of AMA(MIT3) and sp100 antibodies as a combined diagnostic marker leads to an improved detection of PBC in patients with SSc. CENP-B and ATA are associated with alkaline phosphatase elevation.