Title: Prevalence of anti-cyclic citrullinated peptide antibody,anti-keratin antibody and IgM rheumatoid factor in patients with early rheumatoid arthritis
Abstract:Objective To assess the diagnostic value of anti -cyclic citrullinated peptide antibody (anti -CCP), anti-keratin antibody (AKA)and IgM rheumatoid factor(IgM-RF) in patients with early rheumatoid arth...Objective To assess the diagnostic value of anti -cyclic citrullinated peptide antibody (anti -CCP), anti-keratin antibody (AKA)and IgM rheumatoid factor(IgM-RF) in patients with early rheumatoid arthritis(RA). Methods This was a retrospective study on 362 patients: 103 patients with early RA (2 years) and 259 patients with non-RA rheumatic diseases with joint discomfort. Sera from each subject was tested for anti-CCP by enzyme linked immunosorbent assay, AKA by indirect immunofluorescence and IgM-RF by latex agglutination test. Results The sensitivity of anti-CCP (72.8%)and IgM-RF (78.6%) for early RA was better than that of AKA (36.9%)(P=0.0000). The specificity of IgM-RF (81.1%) was lower when compared to that of anti-CCP ( 94.2%) or AKA (90.7%) (P=0.0000 and 0.0019). The average of anti-CCP titer in patients with anti-CCP (+) RA was (85.77+58.20)RU/ml and was higher than that in patients with anti-CCP (+) non-RA rheumatic diseases (median 20.06RU/ml, range 5.2~100.6) (P0.05). Anti-CCP combined with IgM-RF, but not others, yieled a moderate sensitivity (61.2%) but a high specificity (97.7%) when these antibodies were randomly combined to diagnose RA. The other combinations had no superiority because of their low sensitivity (33.0%) or poor specificity (86%). Conclusions It seems that anti-CCP is an important diagnostic parameter for early RA and the value of AKA and IgM-RF for early RA is limited because of its poor sensitivity and specificity respectively. When these antibodies are combined for the diagnose of RA, a careful analysis should be taken to avoid misdiagnosis.Read More
Publication Year: 2009
Publication Date: 2009-01-01
Language: en
Type: article
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