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Anti-cyclic citrullinated peptide (anti-CCP) antibodies are highly specific for RA, but are not detectable in all RA patients. The aim of this study was to establish whether the clinical phenotypes of anti-CCP positive and negative disease are distinct at the earliest clinically apparent phase of disease.Patients were recruited from the Birmingham early inflammatory arthritis clinic. Participants were included in the current study if they presented within 3 months of symptom onset and fulfilled 1987 ACR criteria for RA at some point during an 18 month follow-up. Data were collected on demographic variables, joint symptoms and tender (n = 68) and swollen (n = 66) joint counts. CRP, ESR, rheumatoid factor and anti-CCP2 status were measured.92 patients were included (48 anti-CCP positive). The anti-CCP positive and negative groups were comparable in terms of demographic variables, inflammatory markers, joint counts and 1987 ACR classification criteria, except that more anti-CCP positive patients were rheumatoid factor positive (83.3% vs. 11.4%, p < 0.01). There was no significant difference in the pattern of joint involvement, except for an increased prevalence of knee joint swelling in anti-CCP positive patients (42.9% vs. 22.2%, p = 0.03).Patients with and without anti-CCP antibodies present in a similar way, even within three months of clinically apparent disease that eventually develops into RA.

Original publication

DOI

10.1186/1471-2474-11-187

Type

Journal article

Journal

BMC musculoskeletal disorders

Publication Date

23/08/2010

Volume

11

Addresses

MRC Centre for Immune Regulation, School of Immunity and Infection, The University of Birmingham, Birmingham, UK.

Keywords

Humans, Arthritis, Rheumatoid, Peptides, Cyclic, Autoantibodies, Diagnosis, Differential, Early Diagnosis, Sensitivity and Specificity, Cohort Studies, Predictive Value of Tests, Immunophenotyping, Adult, Aged, Middle Aged, Female, Male, United Kingdom