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Year : 2018  |  Volume : 32  |  Issue : 1  |  Page : 40-46

A clinical study of acute-phase reactants and immunological markers in patients of chronic inflammatory arthritis in a tertiary care setting

Department of Medicine, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India

Correspondence Address:
Dr. Varsha Shirish Dabadghao
F 5/10, Salunke Vihar, Pune, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jms.jms_113_16

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Context: Chronic inflammatory arthritis (IA) refers to a joint disease with pain, morning stiffness more than 30 min, redness, and swelling, lasting for more than 6 weeks. Aims: This study was conducted to evaluate the pattern of joint involvement of these patients, evaluate etiologies, and delineate acute-phase reactants and immunological markers. An attempt was made to correlate the severity of joint involvement with acute-phase reactants and immunological markers. Settings and Design: This was a descriptive, cross-sectional study conducted for 24 months. Subjects and Methods: One hundred patients with clinically diagnosed chronic IA fulfilling criteria for inflammation and lasting more than 6 weeks were studied clinically and by laboratory parameters. Patients with vague, noninflammatory, periarticular or acute disease were excluded from the study. Statistical Analysis Used: Data was collected and analyzed using Epi Info version 7. Chi-square and Fisher's exact tests were applied. Results: The mean age of affection was 40 ± 15 years. A total of 77 patients were female and 23 were male. Seventy-six patients had rheumatoid arthritis (RA), seven had ankylosing spondylitis, six had systemic lupus erythematosus, four had mixed connective tissue disease (MCTD), four had gout, one had juvenile idiopathic arthritis, one had systemic sclerosis, and one had overlap syndrome. Erythrocyte sedimentation rate was raised in 66% of patients, and C-reactive protein (CRP) was raised in 57%. Of the RA patients, 42.1% were rheumatoid factor (RF) positive and 91.5% were anti-cyclic citrullinated polypeptide (CCP) positive. Out of 44 patients who were RF negative, positivity for anti-CCP was 86.1%, which was found significant. Nearly 6.52% of the patients were seronegative. Overall, the correlation of severity of joint involvement with CRP was significant. In RA, severity correlated with CRP, RF, and anti-CCP. Conclusions: RA was the most common etiology (76%) and in it, the positivity of RF was 42.1% and anti-CCP was 91.5%. Overall, the severity of joint involvement was significantly correlated with CRP.

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