Rheumatic Complaints and Anti-CCP Antibodies in Patients With Cronh’s Disease

Abstract

Introduction: Extraintestinal manifestations such as fatigue, fever, and weight loss are a frequent feature in most patients with Crohn’s Disease (CD). Although be multiple organs may be affected in CD, most frequently target organs are joints, skin, and mucous membranes, eyes, liver, and kidneys. Arthropathy is by far the most common extraintestinal manifestation, with frequency ranging from 4-23%. Some studies have shown that up to 70% of patients with spondyloarthritis (SpA) have inflammatory intestinal lesions and up to 26% of patients with SpA have intestinal abnormalities compatible with CD. Anti-cyclic citrullinated peptide (anti-CCP) and rheumatoid factor (RF) are the most studied autoantibodies linked to rheumatoid arthritis (RA). Anti-CCP may appear years before the clinical onset of the disease and are considered highly specific for RA. In the Brazilian population with CD, information about arthralgia, SpA, and RA are scarce. The present study aimed to investigate anti-CCP antibodies and RF in patients with CD from southern Brazil. Additionally, were evaluated clinical manifestations of arthralgia and SpA. Methods: Patients previously diagnosed with CD at the gastroenterology unit from the Clinics Hospital of the Federal University of Paraná were included consecutively. Diagnosis of CD was done by clinical data, imaging tests, endoscopic, and histological findings. A total of 100 patients were included, being 60% female with mean age of 41.9±12.04 years (16-83 years). Demographic and clinical data were collected from charts revision. As control group, we studied the sera from 100 healthy individuals from the same geographic area. Results: Arthralgia complaints were reported in 55% of the patients, being more frequent in women (65.5%, 36/55) followed by 34.5% of males (19/55). There were no association between presence of arthralgia and the type of treatment. Six patients (6/100) had SpA diagnosed and were accompanied by the rheumatology unit. Among the CD patients, anti-CCP was positive only in 1 patient (1%), while RF was positive in 7 patients (7%; 7/100). The anti-CCP positive patient, woman, 38-years-old, RF positive, filled the criteria and was diagnosed with RA. In the control group, anti-CCP antibodies also were detected in 1/100 (1%) and RF was positive in 6/100 (6%) of the samples. Conclusion: Our data show that Brazilian patients with CD have a high prevalence of arthralgia, with 6% of them being diagnosed with SpA. Additionally, we demonstrated low occurrence of anti-CCP antibodies and RF in patients with CD.