IS SERONEGATIVE SPONDYLOARTHRITIDES (SSA) TRULY SERONEGATIVE? IGG -RHEUMATOID FACTOR, ANTI-NUCLEAR AB, AND ANTICARDIOLIPIN AB CAN BE POSITIVE IN SSA ALSO

Background : Seronegative Spondyloarthritides is a very common problem in our area. Etiopathogenesis of the disease is not clear. Rheumatoid arthritis factor (RA factor) and anti CCP antibody which are diagnostic marker of RA are absent in Seronegative Spondyloarthritides. Hence it is called Seronegative. Aim of the present study is to see some autoantibodies of RA and SLE in SSA patients. Method: HLA B27 was done by PCR SSP method. Only HLA B27 positive cases were taken. IgM RF, IgA RF, IgG RF, anti CCP antibodies, ANA, ds DNA were done by ELISA technique. Total 90 cases of SSA and 43 healthy control cases were studied within a period of 1 year. Result: IgM RF, IgA RF and IgG RF was positive in 5.5%, 8.9% and 37.8% cases of SSA respectively while in control only 4.7% were IgA RF positive and 18.6% were IgG RF positive. Anticyclic citrullinated peptide(CCP) Abs were not detected in healthy control but it was positive in 11.11% cases of SSA. All these patients had polyarthritis. ANA and ds DNA was positive in 13.3% and 7.8% cases of SSA respectively. Taking together 5.6% were positive for both ANA and ds DNA. Conclusion: Although clinically none of the patients had feature of SLE. Positivity of IgG RF and ANA was statistically significant. Anticardiolipin Ab (ACLA) was positive in 15.6% of SSA and 11.6% cases of control cases which were no significant. Thus our study concludes that SSA also have autoimmune basis.