National Journal of Laboratory Medicine (Jul 2014)

Diagnostic utility of Anti-cyclic Citrullinated Peptide Antibodies for Very Early Rheumatoid Arthritis

  • Sucilathangam G,
  • Anna T,
  • Velvizhi G

DOI
https://doi.org/10.7860/NJLM/2014/9390:2011
Journal volume & issue
Vol. 3, no. 3
pp. 1 – 4

Abstract

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Background and Objectives: Rheumatoid arthritis (RA) is a systemic autoimmune disorder characterized by widespread joint inflammation with synovial hyperplasia. The most well known diagnostic marker is rheumatoid factor (RF).However; RF is not a good marker for RA, because it can be detected in autoimmune disorders other than RA as well as in 3-5% of healthy individuals. Recent studies indicated that Anti-CCP testing is particularly useful in the diagnosis of RA with high specificity present early in the disease process. Therefore, we aimed in our study to evaluate the diagnostic performances of anticyclic Citrullinated peptides antibody (anti-CCP) ELISA and Rheumatoid Factor in a group of patients with RA and non RA patients in Tirunelveli. Materials and Methods: This prospective study, which was carried out for a period of six months in a tertiary care hospital. Blood was collected with informed consent in 65 RA patients and 30 non RA patients and serum was subjected to Rheumatoid Factor latex kit (AGAPPE Diagnostics, Kerala) and anti-CCP antibody detection by Enzyme Linked Immunosorbent assay (Euroimmun, Germany) with the cut-off at 8 IU/ml and 5 RU/ml respectively. The cutoff values recommended by the respective manufacturers were used to determine the sensitivity and specificity. Results: This study shows that Sensitivity of anti-CCP was 58.3% with better specificity (100%) in RA patients whereas Sensitivity of anti-CCP was 50% with specificity (89.3%) in non RA patients. The combination of Rheumatoid factor (RF) and antibodies against cyclic Citrullinated provide better specificity to anti-CCP assay. Conclusion: Anti-CCP assay could be a useful serological test for the diagnosis of patients with early stages of RA, because anti-CCP revealed higher diagnostic specificity than RF. The high specificity of anti-CCP antibodies is particularly useful in RF-negative RA patients. Anti-CCP antibodies are more specific than RF for diagnosing rheumatoid arthritis. In Sudanese patients with RA, antiCCP antibodies exhibit a better diagnostic value than RF.

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