The aim of this study is to determine the prevalence of antikeratin antibodies (AKA)
in the sera of rheumatoid arthritis (RA) patients and to assess their clinical significance
in evaluation of disease activity and severity.
Serum samples from 90 patients with RA and 60 healthy control subjects were tested.
AKA titres were estimated by indirect immunofluorescence (IIF) technique.
A positive AKA test was highly specific for RA (diagnostic specificity 96.7%) being
found in 70% of the patients. Although IgM RF had a higher sensitivity, it was less
specific for RA (93.3%). The diagnostic specificity was greatest when tests for AKA and
RF were found in combination (98.3%). Fifteen of our RA patients had disease duration
less than one year, 10 of them were AKA +ve (66.7%) and 75 had disease duration more
than one year, 53 of them were AKA +ve (70.7%). There was insignificant difference
between both groups as regard AKA titre (P>0.05). There were highly significant
differences as regard AKA titre in RA patients graded according to their functional
capacity, disease activity and radiological grading of severity being higher in higher
grades (P<0.001).
In conclusion, our data suggest that AKA is highly specific serological marker for
RA and determination of AKA will be of value in the diagnosis of early and late cases of
RA. The presence of RF and AKA strongly indicate RA. Furthermore, AKA may have
some prognostic significance because of their association with more severe and active
forms of the disease. |
