The Korean Journal of Medicine

  • 제83권2호
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  • Pages.174-177
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  • 2012
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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관절염의 검사실 소견

Laboratory Findings in the Patients with Arthritis

  • 박용욱 (전남대학교 의과대학 류마티스내과학교실)
  • Park, Yong-Wook (Department of Rheumatology, Chonnam National University Medical School and Hospital)
  • 발행 : 2012.08.01
⟨ 이전 논문 다음 논문 ⟩

초록

Arthritis is caused by various diseases including rheumatoid arthritis (RA), osteoarthritis, gout and trauma, and joint involvement also occurs in some autoimmune diseases, such as systemic lupus erythematosus and Sj$\ddot{o}$gren's syndrome. Some laboratory tests provide useful information in both diagnosis and prognosis. RF and anti-CCP (cyclic citrullinated peptide) antibody are detected in approximately 70-80% of patients with RA, and often associated with a worse prognosis (e.g., bony erosion and joint deformity). Acute phase reactants, such as erythrocyte sedimentation rate and C-reactive protein, parallel the activity of RA, and their persistent elevation are also associated with a poor prognosis. Crystal examination in synovial fluid is essential to confirm the diagnosis of gout and pseudogout, and the synovial fluid culture is also important in septic arthritis. Anti-nuclear antibody helps to distinguish non-immune arthritis from systemic rheumatic diseases. However, arthritis cannot be diagnosed only with laboratory findings, and physician should consider comprehensive physical examination, clinical findings, and imaging findings as well as laboratory findings. In this topic review, laboratory tests useful for diagnosis of arthritis will be discussed and summarized.

키워드

참고문헌

  1. Visser H. Early diagnosis of rheumatoid arthritis. Best Pract Res Clin Rheumatol 2005;19:55-72. https://doi.org/10.1016/j.berh.2004.08.005
  2. Bas S, Genevay S, Meyer O, Gabay C. Anti-cyclic citrullinated peptide antibodies, IgM and IgA rheumatoid factors in the diagnosis and prognosis of rheumatoid arthritis. Rheumatology (Oxford) 2003;42:677-680. https://doi.org/10.1093/rheumatology/keg184
  3. Shmerling RH, Delbanco TL. The rheumatoid factor: an analysis of clinical utility.Am J Med 1991;91:528-534. https://doi.org/10.1016/0002-9343(91)90190-9
  4. Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 2010;69:1580-1588. https://doi.org/10.1136/ard.2010.138461
  5. Dubucquoi S, Solau-Gervais E, Lefranc D, et al. Evaluation of anti-citrullinated filaggrin antibodies as hallmarks for the diagnosis of rheumatic diseases. Ann Rheum Dis 2004;63: 415-419. https://doi.org/10.1136/ard.2003.008623
  6. Avouac J, Gossec L, Dougados M. Diagnostic and predictive value of anti-cyclic citrullinated protein antibodies in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis 2006;65:845-851.
  7. Van Gaalen FA, Linn-Rasker SP, van Venrooij WJ, et al. Autoantibodies to cyclic citrullinated peptides predict progression to rheumatoid arthritis in patients with undifferentiated arthritis: a prospective cohort study. Arthritis Rheum 2004;50:709-715. https://doi.org/10.1002/art.20044
  8. Rantapää-Dahlqvist S, de Jong BA, Berglin E, et al. Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis. Arthritis Rheum 2003;48:2741-2749. https://doi.org/10.1002/art.11223
  9. Van der Helm-van Mil AH, Verpoort KN, Breedveld FC, Toes RE, Huizinga TW. Antibodies to citrullinated proteins and differences in clinical progression of rheumatoid arthritis. Arthritis Res Ther 2005;7:R949-R958. https://doi.org/10.1186/ar1767
  10. Campion EW, Glynn RJ, DeLabry LO. Asymptomatic hyperuricemia: risks and consequences in the Normative Aging Study. Am J Med 1987;82:421-426. https://doi.org/10.1016/0002-9343(87)90441-4
  11. Faraj AA, Omonbude OD, Godwin P. Gram staining in the diagnosis of acute septic arthritis. Acta Orthop Belg 2002; 68:388-391.
  12. Von Essen R, Hölttä A. Improved method of isolating bacteria from joint fluids by the use of blood culture bottles. Ann Rheum Dis 1986;45:454-457. https://doi.org/10.1136/ard.45.6.454
  13. Kavanaugh A, Tomar R, Reveille J, Solomon DH, Homburger HA. Guidelines for clinical use of the antinuclear antibody test and tests for specific autoantibodies to nuclear antigens:American College of Pathologists. Arch Pathol Lab Med 2000;124:71-81.
  14. Machold KP, Stamm TA, Nell VP, et al. Very recent onset rheumatoid arthritis: clinical and serological patient characteristics associated with radiographic progression over the first years of disease. Rheumatology (Oxford) 2007;46:342-349.
  15. Combe B, Dougados M, Goupille P, et al. Prognostic factors for radiographic damage in early rheumatoid arthritis: a multiparameter prospective study. Arthritis Rheum 2001; 44:1736-1743. https://doi.org/10.1002/1529-0131(200108)44:8<1736::AID-ART308>3.0.CO;2-I