“…35,36 In previous studies was shown that ACPA-positive ASS patients may show overlapping features of RA-ASS and may develop refractory erosive arthritis. 5,36 Only a few case reports describe ASS complicating the course of RA. [5][6][7][8][9][10][11] In general, there is little justification for requesting tests for anti-ENA autoantibodies unless the ANA test is positive.…”