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cyclic citrullinated peptide antibody in serum; anti-citrulline antibody in serum; anti-CCP in serum

Indications: rheumatoid arthritis Clinical significance: - 70% sensitivity for RA; specificity for RA 95% - anti-CCP is less sensitive than rheumatoid factor (RF), but more specific for RA (95% vs 85-90%)* - may be elevated in rheumatoid factor-negative rheumatoid arthritis - anti-CCP positive in 40-60% of patients early in the course of RA when RF may be negative [3] - presence of rheumatoid factor & anti-CCP Ab makes diagnosis of RA more likely [5] - presence associated with erosions - predicts disease progression in undifferentiated arthritis [3] - levels > 3-fold upper limit of normal associated with increased risk for development of rheumatoid arthritis [6] * anti-CCP Ab may occur in - rheumatologic disease other than rheumatoid arthritis - active tuberculosis - chronic lung disease [5]

Related

citrulline cyclic citrullinated peptide antibody; anti-citrulline antibody; anti-CCP

Specific

cyclic citrullinated peptide (CCP) IgA Ab in serum/plasma cyclic citrullinated peptide (CCP) IgA+IgG Ab in serum/plasma cyclic citrullinated peptide (CCP) IgG Ab in serum/plasma

General

serology

References

  1. CCP Lab Tests Online: ccp
  2. Shmerling RH Testing for anti-cyclic citrullinated peptide antibodies: is it time to set this genie free? Arch Intern Med. 2009 Jan 12;169(1):9-14. Review. PMID: 19139318
  3. Medical Knowledge Self Assessment Program (MKSAP) 14, 16, 17. American College of Physicians, Philadelphia 2006, 2012, 2015
  4. Whiting PF, Smidt N, Sterne JA et al Systematic review: accuracy of anti-citrullinated Peptide antibodies for diagnosing rheumatoid arthritis. Ann Intern Med. 2010 Apr 6;152(7):456-64; W155-66 PMID: 20368651
  5. Veterans Administration
  6. Ford JA, Liu X, Marshall AA et al. Impact of cyclic citrullinated peptide antibody level on progression to rheumatoid arthritis in clinically tested cyclic citrullinated peptide antibody-positive patients without rheumatoid arthritis. Arthritis Care Res (Hoboken) 2019 Dec; 71:1583. PMID: 30570827 https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.23820