Clinical and immunological features of rheumatoid arthritis patients with positive anti-centromere antibody: a case-control study

Objective To characterize the clinical and immunological features of rheumatoid arthritis (RA) patients with positive anti-centromere antibody (ACA). Methods In this retrospective case-control study, the clinical manifestations, demographic data, and immunological test results of these patients were collected and analyzed. Results ACA-positive RA patients exhibited a significantly higher prevalence of Raynaud’s phenomenon (15.0% vs. 2.5%, χ 2 = 4.838, P = 0.028), xerostomia (22.5% vs. 8.8%, χ 2 = 4.363, P = 0.037), xerophthalmia (27.5% vs. 10.0%, χ 2 = 6.128, P = 0.013), and interstitial pneumonia (27.5% vs. 5.0%, χ 2 = 12.343, P < 0.001), as well as higher rates of elevated ALP (18.9% vs. 1.3%, χ 2 = 9.780, P = 0.002) and GGT (33.33% vs. 15.0%, χ 2 = 5.086, P = 0.024). Conclusion ACA-positive RA may present a unique phenotype characterized by an increased risk of interstitial lung disease, sicca symptoms, and cholestatic liver injury; thus, enhanced pulmonary/hepatic screening and tailored monitoring strategies are critical.