Anti ccp and rheumatoid factor in rheumatoid arthritis – clinical and radiological significance

Objective : To estimate anti CCP titres, rheumatoid factor, CRP in rheumatoid arthritis and correlate with disease activity and joint erosion. Methods: 100 patients with history of pain selected for study for a period of two years, 50 were of rheumatoid arthritis and the rest were of non-specific and inflammatory arthritis. Clinical assessment with radiology done coupled with serological estimations of CReactive Protein, Rheumatoid Factor and anti-CCP titres. Results: The sensitivity and specificity of anti-CCP reactivity for the diagnosis of rheumatoid arthritis were 70.3% and 92.4%, respectively whereas, the sensitivity and specificity of Rheumatoid Factor for RA were 68.6% and 80.2%. Furthermore, 4 seronegative patients with RA demonstrated reactivity to CCP. The presence of either anti-CCP or RF increased testing sensitivity for diagnosis of RA to 77.6%;the presence of both RF and anti-CCP demonstrated a testing specificity similar to that of anti-CCP reactivity alone for the diagnosis of RA (93.1%).Conclusion: The detection of anti-CCP is useful for the diagnosis of RA, even more than RF because of its higher specificity . Combination of anti CCP , RF and ultrasonography helps in diagnosis of RA , evaluating the severity of disease activity and joint affection .