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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2020, Number 4

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An Med Asoc Med Hosp ABC 2020; 65 (4)

Scleritis and anti-cyclic citrullinated peptide antibody as initial presentation of rheumatoid arthritis

Ruiz-Cruz M, Hübbe-Tena C, Prado-Larrea C, Cheja-Kalb R, Concha-del-Río LE

Language: Spanish
References: 28
Page: 262-269
PDF size: 361.94 Kb.


ABSTRACT

Introduction: Rheumatoid arthritis is a chronic autoimmune disease that primarily involves joints, with severe eye disease being part of the extra-articular manifestations. In these patients, it has been described a strong association with the presence of anticyclic citrullinated peptide antibodies. Objective: To describe ocular disease (scleritis, sclerouveitis, diffuse scleritis) with anticyclic citrullinated peptide antibodies and the absence of joint manifestations as an early presentation of patients who later develop rheumatoid arthritis. Material and methods: Retrospective, observational and descriptive case-series. Medical records of patients diagnosed with scleritis who attended the Inflammatory Eye Disease Clinic of the Asociación para Evitar la Ceguera from 2010-20, were reviewed. Results: Five patients who presented with ocular manifestations (nodular or diffuse scleritis, sclerouveitis, scleromalacia) without rheumatoid arthritis symptoms were included. All patients were positive for anticyclic citrullinated peptide antibodies, two patients had abnormal rheumatoid factor and none of them met the American College of Rheumatology/European League Against Rheumatism 2010 classification criteria for rheumatoid arthritis at baseline. Throughout follow-up, three patients developed rheumatoid arthritis. All patients started with oral steroids treatment and disease-modifying anti-rheumatic drugs in four of them. Conclusions: A multidisciplinary approach between rheumatologist and ophthalmologist is essential in patients who debut with positive anticyclic citrullinated peptide antibodies and only ocular involvement, without joint manifestations, in order to establish early treatment and avoid ocular complications. IV


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EVIDENCE LEVEL

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