Analysis of rheumatoid factor and anti-cyclic citrullinated peptide in individuals with rheumatalogical disorders attending a tertiary care hospital (original) (raw)
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Comparative study of anti-CCP and RF for the diagnosis of rheumatoid arthritis
APLAR Journal of Rheumatology, 2007
Aim: To determine the frequency of anti-cyclic citrullinated peptide antibody (anti-CCP) in a group of patients with rheumatoid arthritis and another group with other rheumatic diseases. Patients and methods: Anti-CCP1 and rheumatoid factor (RF) titres were determined in 320 serum samples; 136 from RA patients, 184 from control patients (165 patients with rheumatic diseases other than RA, and 21 patients with lymphoproliferative diseases). Results: The sensitivity of Anti-CCP was 62.5% (95% CI: 53-70%) for the diagnosis of RA with a specificity of 89.1% (95% CI: 83-93%). The sensitivity of RF was 85.3% (95% CI: 79-91%). The specificity was 64.7% (95% CI: 57-71%). Conclusions: Anti-CCP1 has not very high specificity for RA regarding other rheumatic disease. However it is still very helpful for the diagnosis of RA.
Clinical Rheumatology, 2007
To compare the diagnostic powers of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) in a population selected for its high statistical relevance, over a 6-month period, an informed consent to test for anti-CCP was obtained from 1,025 consecutive patients for whom RF was ordered at a University laboratory. Within 1 year, a diagnosis was obtained without informing the physician about the anti-CCP result. Extensive statistical analyses were performed. A total of 768 patients satisfied the inclusion criteria, and 132 were classified as having RA, yielding a pre-test probability of RA of 17%. The sensitivities for anti-CCP and RF were 62 and 64% (P= 0.83), and the specificities were 97 and 90% (P<0.001), respectively. The positive predictive value (PPV) was 79% for anti-CCP and 56% for RF (P<0.001), whereas the negative predictive value was 92% for both. The likelihood ratio (LR) was 17.9 for anti-CCP and 6.2 for RF (P< 0.005). Forty RA patients were diagnosed with RA of less than 2 years length, and the same significant statistic differences between anti-CCP and RF were observed. Placing the results of both tests together, or using different cutoff points, increased the diagnostic utility of the tests. The anti-CCP test has statistically shown significant higher specificity, PPV, and LR for RA than the RF test in a clinically diverse population. If new criteria are to be devised to help diagnose early RA, anti-CCP should be included because it has a greater diagnostic impact than RF.
The aim of this study was to evaluate the performance of anti-cyclic citrullinated peptide antibodies (anti-ccp) versus Rheumatoid Factor (RF) in the diagnosis of rheumatoid arthritis in serum sample of patients with clinical manifestation of arthritis using ELISA technique. One hundred and twenty patients with clinical presentation of rheumatoid arthritis and fifty apparently healthy individuals (25 males and 25 females) were enrolled in this study. The mean age of patients group and control was 36.45years versus 34.72 years .Among patients, males represented (8.3%) compared with (91.7%) of females. In control group males represented (52%) versus (48%) females. There was a statistical significant difference (p>0.05) between patients and control group in RF and anti-ccp values. Eighty five percent of patients gave positive results for anti-ccp compared with (100%) negative results in control group. RF was detected in (41.66 %) of patients sera compared with (58.33 %) which gave negative results. RF ELISA gave negative results in (100%) of control group . Only 10(8, 33%) out of 120 patients gave negative results in RF and anti-ccp ELISA, compared with 42(35%) out of 120 gave positive results in both tests. In 60(50%) out of 120 RA patients RF gave negative results and at the same time gave positive results when retested using anti-ccp ELISA .Only 8(6.66%) out of 120 RA patients gave negative result in anti-ccp ELISA technique and RF was detected in positive value. The sensitivity of anti-ccp ELISA was (85%) versus (41.66%) for RF. The Specificity of anticcp ELISA was (55.55%) versus (14.28%) for RF. Positive predictive value for anti-ccp ELISA was 41.17% versus (84%) for RF. Negative predictive value for anti-ccp ELISA was 55.55% versus 14.28 for RF ELISA .False positive value in anti-ccp ELISA was 58.82% versus 16%for RF ELISA. False negative value in anti-ccp ELISA was 44.44% versus 85.71%for RF . This study concludes that anti-ccp ELISA was more sensitive and specific in diagnosis of RA than RF ELISA technique.
2016
The rheumatoid arthritis (RA) is an auto-immune, rheumatic and chronic inflammatory disease, characterized by joints damage. The early diagnosis of RA allows the initiation of a treatment which offers to the patients more chance of remission and avoids the evolution towards the unrecoverable deformity of joints. The objective of this study is to evaluate the performance of recent tests for the determination of anti-CCP antibodies and FR by ELISA in Benin Republic. This analytical, retrospective (2 years 6 months) and prospective (7 months) study allowed us to collect 36 patients meeting the American College of Rheumatology (ACR) criteria for RA and 24 controls. A comparison was made with the latex agglutination test for rheumatoid factors and a search of rheumatoid factors (RF) on the one hand and anti-cyclic citrullinated peptide. In our study, the specificity of anti-CCP assay (100 %) is higher than that of RF-ELISA (91.7%). The sensitivity of RF-ELISA assay is higher (77.8 %) than that of anti-CCP assay (66.7%). The latex test for rheumatoid factors has a sensitivity of 33.3 %. The positive predictive value (PPV) of anti-CCP assay (100 %) is higher than that of RF-ELISA assay (93.33 %). The positive-likelihood ratio (LR+) of anti-CCP assay is higher than the LR+ of RF-ELISA assay (4.96). The negative-likelihood ratio (LR-) of anti-CCP assay (0.33) is higher than the LR-of RF-ELISA assay (0.24). In conclusion, the anti-CCP assay has the highest specificity and RF-ELISA assay shows the highest sensitivity. In conclusion, the association of the two assays enhances a better diagnosis value for RA.
Clinical Rheumatology, 2010
To establish the diagnostic utility of the anticyclic-citrullinated peptide antibody (aCCP) test in Black South Africans with early rheumatoid arthritis (RA). A cross-sectional study comparing the rheumatoid factor (RF) and aCCP status in RA patients and a control group consisting of healthy subjects, and patients with systemic lupus erythematosus (SLE) and scleroderma. The sensitivity, specificity, positive (PPV) and negative predictive values of the aCCP test alone were 82.5%, 84.9%, 87.6% and 79% versus 81.7%, 90.7%, 92.5% and 78% for RF alone. The best specificity (95.3) and PPV (95.8%) was observed when both aCCP and RF tests were positive. Patients with erosive disease had a significantly higher mean RF titre compared with those with non-erosive disease (p=0.007). There was a trend towards an association of smoking (OR=4.1, 95% CI=0.9-18.6) and functional disability (p=0.07) with RF-positive status. No similar clinical associations were observed with aCCP. Almost a third of SLE patients were aCCP positive. Despite the best specificity and PPV observed when both the aCCP and RF tests were positive, our findings suggest that testing for aCCP is only cost-effective in the RF-negative patient in whom there is a strong clinical suspicion of RA.
INDIAN JOURNAL OF APPLIED RESEARCH, 2020
Background: Rheumatoid arthritis (RA) is an autoimmune disease associated with chronic inflammation of joints causing deformities and functional impairment. Rheumatoid factor (RF) is an autoantibody specific for the Fc portion of human IgG. RF has low specificity as high false positive results are common in the general population. Anti CCP (Anti-cyclic citrullinated peptide) antibody is also a useful marker to diagnose rheumatoid arthritis and included in one of the criteria of the American College of Rheumatology (ACR) /European League against Rheumatism (EULAR) classification of RA. This study is done to compare the diagnostic utility of Anti CCP and RF test in RA patients. Aim & Objective: Comparison of rheumatoid factor (RF) and Anti cyclic citrullinated peptide (Anti -CCP) antibodies in diagnosis of rheumatoid arthritis- in a tertiary care hospital. Material &Methods: A total of 70 samples were taken from clinically suspected RA patients over a period of 6 months.RF and AntiCCP...
IP Innovative Publication Pvt. Ltd., 2017
Introduction: Rheumatoid arthritis (RA) is autoimmune disease associated with chronic inflammation of joints causing deformities and functional impairment. Diagnosis primarily depends on clinical manifestations because of lack of suitable diagnostic tests. Rheumatoid factor (RF) is an autoantibody specific for Fc portion of human IgG. RF has low specificity as high false positive results are common in general population. Anti CCP antibody is also useful marker to diagnose rheumatoid arthritis and included in one of the criteria of American College of Rheumatology (ACR) /European League against Rheumatism (EULAR) classification of RA. Thus the present study was planned to compare the diagnostic utility of RF and Anti CCP antibody test in Rheumatoid arthritis patients in a Tertiary Care Hospital. Aim & Objective: To compare the diagnostic utility of RF and Anti CCP antibody test in Rheumatoid arthritis patients. Material & Methods: A total of 72 samples were taken from clinically suspected RA patients over a period of 3 months. RF was determined by latex agglutination method (STAR DIAGNOSTICS) and Anti CCP antibody by ELISA (IMTEC ANTI CCP ANTIBODIES ELISA-GERMANY). The tests were performed as per manufacturer's instructions. Results & Discussion: Out of total 72 samples tested, 47(58.33%) were positive. Both RF and Anti CCP Antibody was positive in 9 cases. Only RF positivity was seen in 8 cases and only Anti CCP antibody was positive in 30 cases. In present study combination of Anti CCP antibody and Rheumatoid factor together have shown positive predictive value for Rheumatoid Arthritis patients which lack specific signs and symptoms related to diagnosis of RA Conclusion: Anti CCP antibody test and RF can be used concomitantly to diagnose Rheumatoid arthritis and can be used in clinical settings so that appropriate management can be initiated to decrease future morbidity.
Introduction: In the last 70 years, Rheumatoid Factor (RF) was considered the most useful laboratory marker in patients with rheumatoid arthritis (RA). The next very important milestone for the RA diagnosis was the discovery of anti-citrullinated peptide/protein antibodies (ACPA). The detection of ACPA is usually done with the CCP test of the second generation, CCP2. Objective: To evaluate the performances of RF and CCP2 tests and to see whether or not the performance of both tests together is better then the performances of either of the tests alone. Materials and Methods: We performed a cross-sectional study with 380 participants of which 155 RA patients who fulfilled the American College of Rheumatology (ACR) 1987 classification criteria for RA, 120 patients with inflammatory and other connective tissue diseases (Non-RA) and 105 healthy controls (HC), at the Rheumatology Clinic in Skopje, Macedonia. The patients and controls were tested for RF and ACPA. Results: The mean age of the RA patients was 50 years, and 87 % of the patients were female. The average duration of the disease has been 6 years. In this group of patients, CCP2 test showed identical sensitivity of 0,69 and better specificity than RF (0,95 vs. 0,87 respectively). For the patients who tested positive for both tests, the sensitivity was lower 0,60 and for the patients who were either ACPA or RF positive, sensitivity was slightly higher 0,73. The specificity of 0,88 for both or either of the tests was identical with that of RF. The positive likelihood ratio was 13,8 for the CCP2 test, 5,3 for RF and 5,1 for both tests done together. Ninety four out of 155 RA patients were positive for both ACPA and RF, 20 patients were positive for either one of the antibodies of which 7 (4,5%) RA patients were only anti-CCP positive and 13 (8,3%) patients were only RF positive. Conclusion: The results from our study showed that the sensitivity and specificity of both tests, done in parallel, does not differ much from the sensitivity of either of the tests alone and from the specificity of RF, respectfully. Still, CCP2 test showed the highest specificity and positive likelihood ratio as was expected. The results from our study support the idea that in countries like Macedonia, which can not afford enough CCP2 antibody kits, we may use RF first, especially in patients who are not likely to meet any clinical criteria for RA. In patients with early undifferentiated arthritis or early RA we may use both antibodies in order to select the patients who will need more aggressive treatment.
Evaluation of Anti-CCP Antibody for Diagnosis of Rheumatoid Arthritis
Clin. Lab, 2011
Background: Rheumatoid arthritis is a common, world wide, systemic disease that affects mainly joints. Rheumatoid factor is the only marker to diagnose rheumatoid arthritis; however these antibodies are present in other disorders and even in up to 15 % of the healthy population. Many auto antibodies have been reported to diagnose rheumatoid arthritis e.g. APF and AKA, etc. but they are not specific and due to tedious laboratory procedure, they have not been generally adopted. Anti-CCP antibodies have been reported for their high sensitivity and specificity. This study was planed to determine the prevalence of anti-CCP antibodies and RA factor in clinically diagnosed patients of rheumatoid arthritis. Methods: Anti-CCP antibody was determined by ELISA technique and RA-factor was done by latex agglutination method. Results: Forty five patients, 36 female and 9 male, were recruited for this study. Twenty-five (55.6 %) patents were positive for anti-CCP antibodies while 20 patients were negative for anti-CCP antibodies and comparison between anti-CCP positive and anti-CCP negative was statistically significant (p = <0.01). Thirty-one (68 %) patients were seropositive (SPRA) for RA while 14 (31 %) patients were seronegative (SNRA). Among SPRA patients, 18 were positive for anti-CCP antibody and among 14 SNRA patients, 7 patients had anti-CCP antibody and the difference between these two groups was not statistically significant. Conclusions: Anti-CCP antibody and RA-factor should be used concomitantly to diagnose RA.