Correlation of hs-CRP Levels with Anti-CCP And Rheumatoid Factor Among Clinically Suspected Rheumatoid Arthritis Cases (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.
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.
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.
International Journal of Current Microbiology and Applied Sciences
Introduction Rheumatoid Arthritis (RA) is the most common systemic inflammatory, auto immune Rheumatic disease of unknown etiology 1,2,3,4 affecting nearly 1% 1,3,5,6,7,8.9,10 of the adult population worldwide. Although the precise aetiology of RA remains unknown 1 , there is strong evidence for autoimmunity, since several auto antibodies are associated with the disease 6. The potential of the synovial inflammation to cause cartilage damage and bone erosions and subsequent changes in joint integrity is the hallmark of the disease. The disease occurs frequently in women than in men (2.5-3:1). The disease can begin at any age, peak onset typically occurs in the fourth and fifth decades of life. 7 Genetic studies have demonstrated that a genetic predisposition resides in the HLA-DR locus. 7,12 For decades, RA is diagnosed primarily according to clinical manifestations based upon ACR criteria 3,5,7,14,15 , in which the only serological marker is RF test. Rheumatoid factor (RF) is an antibody directed against the Fc region of IgG that has been used as a diagnostic marker for Rheumatoid Arthritis. 2,3,6,7,16. and is recommended as a screening test 3 and can be
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.
Clinica Chimica Acta, 2012
Introduction: Rheumatoid arthritis (RA) is an inflammatory autoimmune disease characterized by chronic joint inflammation and extra-articular manifestations, eventually leading to permanent disability without early therapeutic interventions. Methods: The analytical and clinical performance of an electrochemiluminescent immunoassay (ECLIA) (Roche Diagnostics, Indianapolis, IN) were determined for cyclic citrullinated peptide antibodies (anti-CCP) in the diagnostic assessment of rheumatoid arthritis compared to a plate-based anti-CCP enzyme immunoassay (EIA) (Inova Diagnostics, Inc.). Results: Imprecision studies on the automated Roche ECLIA demonstrated intra-assay CV's of b 3% and interassay CV's of b7%. The Inova EIA had intra-assay CV's of b 15% and inter-assay CV's of b 12%. The limit of quantitation of both assays was acceptable, and both assays showed similar linearity within the manufacturer's defined reportable ranges. Overall, analytical concordance was 62%, with 95.2% positive and 53.2% negative concordance. The clinical specificity in a normal population (n = 91) was 98.9% and 100% for Roche ECLIA and Inova EIA, respectively. The clinical specificity in a connective tissue disease population (n = 98) was 91.9% (95%CI, 86.0 to 96.5%) and 88.8% (95% CI, 81.0 to 93.6%) for Roche ECLIA and Inova EIA, respectively. Conclusion: The Roche ECLIA demonstrated similar analytical performance, although with improved intraassay precision, in comparison to the Inova EIA. The two methods also demonstrated similar clinical sensitivity and specificity. The Roche automated immunoassay is a viable alternative to the plate-based EIAs with the advantage of being performed on an automated platform.
A study of high sensitive C-reactive protein in rheumatoid arthritis patients
2020
Background: Rheumatoid arthritis (RA) is not only merely limited to joints but has many extraarticular features. The major cause of mortality in RA is cardiovascular disease (CVD). Inflammation in RA predispose them to succumb to CVD. The aim of this study to observe whether therapy with disease-modifying anti-rheumatic drugs (DMARD) decreases inflammation and if it does so than it can be said that decrease the risk to develop CVD. Aim and objectives were to assess hs-CRP level in early and established RA both at diagnosis and again at 3 months of DMARD therapy and compare between them.Methods: Total 58 early RA (group A) and 58 established (group B) DMARD naïve RA patients were included in the study. Age, BMI, haemoglobin, random blood sugar, lipid profile, ESR, hs-CRP, RA factor and anti-CCP were measured. All of them were treated with DMARD and hs-CRP was again assessed after 3 months.Results: The mean hs-CRP level at diagnosis was 6.14±1.90 mg/l in group A while it was 10.39±3.1...
Anti-CCP is not a marker of severity in established rheumatoid arthritis: An MRI study
Imaging and radiation research, 2007
Introduction: the presence of anti-CCP is an important prognostic tool for rheumatoid arthritis (RA), but its relationship with the activity of the disease and functional capacity is still being investigated. Objectives: to study the relationship between anti-CCP and the indices of disease activity, functional capacity and structural damage, by means of conventional radiography (CR) and magnetic resonance imaging (MRI), in stabilized RA. Methods: cross-sectional study of RA patients with one to 10 years of disease. The participants were subjected to clinical evaluation with anti-CCP screening. Disease activity was assessed by means of the Clinical Disease Activity Index (CDAI) and functional capacity by means of the Health Assessment Questionnaire (HAQ). CR was analyzed by the Sharp van der Heijde index (SmvH) and MRI by the Rheumatoid Arthritis Magnetic Resonance Image Scoring System (RAMRIS). Results: 56 patients were evaluated, with median (IIq) of 55 (47.5-60.0) years, 50 (89.3%) were female among whom 37 (66.1%) were positive for anti-CCP. The median (IIq) of CDAI, HAQ, SmvH and RAMRIS were 14.75 (5.42-24.97), 1.06 (0.28-1.75), 2 (0-8) and 15 (7-35), respectively. There was no association between anti-CCP and CDAI, HAQ, SmvH and RAMRIS. Conclusion: our results did not establish the association of anti-CCP with the severity of the disease. So far, we cannot corroborate the anti-CCP as a prognostic tool in RA established.
"Association of Anti-CCP Antibodies with Disease Activity in Rheumatoid Arthritis"
Background: Rheumatoid arthritis (RA) is an autoimmune disease and it is characterized by the production of autoantibodies specific for the disease like rheumatoid factor, antibodies against cyclic citrullinated peptides (Anti-CCP), antinuclear autoantibodies (ANA) etc. We have very few specific data regarding these issues.. In total 165 patients with RA attended the mentioned units with proper documents were finalized as the study population. A pre-designed semi-structured questioner was used in collecting patient data. All data were collected, processed, analyzed and disseminated by MS-Office and SPSS version 20 as per need. Result: In this study, the DAS 28 score was significantly higher in anti-CCP positive patients than anti-CCP negative patients (6.3±0.92 vs. 5.9±0.8, p = 0.017). The number of tender joint count and swollen joint count were significantly higher in the anti-CCP positive group than those in the anti-CCP negative group (31±12 vs. 24±12, p=0.003; 6±5 vs. 3±2, p=0.002 respectively). ESR (mean±SD) was 61.7±31.4 in Anti-CCP positive group and 48.9±19.6 in Anti-CCP negative group, which was significantly higher in the Anti-CCP positive group (P=0.032). Anaemia was significantly higher in Anti-CCP positive group (55.3% vs. 33.3%, p=0.023). Patient's global assessment of disease activity and physician's global assessment of disease activity were also higher in the Anti-CCP positive group than negative group, which was nearly significant (57.0±15.4 vs. 52.7±9.8, p-0.054; 51.0±15.6 vs. 45.2±12.5, p= 0.053 respectively). On the other hand, there was no statistically significant difference in term of disease duration, VAS, HAQ, morning stiffness > 60 minutes, CRP, Haemoglobin, platelet count and joint deformity (p> 0.05). In comparison of disease activity indices level between Anti-CCP positive and negative patients with RA we observed DAS 28 was not associated with anti-CCP positivity (P=0.410), HAQ score < 1 was significantly less in patients with anti-CCP negativity (P=0.02), patient's global assessment and physician's global assessment score were much higher in the anti-CCP positive group and number of tender joint count was significantly higher in the former group. Conclusion: Anti-CCP antibodies test should be continued for diagnosis of rheumatoid arthritis especially for the RF negative rheumatoid arthritis patients. Anti-CCP antibody test does not appear to be useful as a marker of disease activity in rheumatoid arthritis.