بررسی اندازه‌گیری آنتی‌بادی ضد سیترولین در تشخیص بیماران مبتلا به آرتریت روماتوئید و مقایسه با سایر بیماری‌های روماتیسمی و افراد به ظاهر سالم

    Background and Aim: Rheumatoid arthritis (RA) is the most common autoimmune rheumatic disease, which requires specific diagnostic tests for it’s’ diagnosis. However specific and practical tests for its diagnosis are lacking. We evaluated the diagnostic accuracy of Anti-cyclic citrullinated peptide antibodies (Anti-CCP) in the diagnosis, prognosis and determination of the severity of RA.Materials and Methods: In a descriptive-cross sectional study Anti-CCP antibodies were determined in 140 serum samples: 82 from RA patients and 58 from controls, including samples of 30 healthy individuals and 28 patients with connective tissue diseases. Anti-CCP was detected by ELISA in the serum samples of patients, Rheumatoid factor of IgA, IgM and IgG classes was determined by ELISA and Anti-Nuclear Antibody was detected by Immunoflourescent method results were compared in the three groups. For comparison of differences between groups t (quantitative variables) and chi-square tests (qualititative variable) tests were used. Correlation between titer of IgM-RF and Anti-CCP was assessed by Pearson’s Correlation test. In addition, Receiver Operating Characteristics (ROC) analysis was carried out to compare sensitivity and specificity of various tests. For data analysis SPSS V. 15 was used.Results: Mean concentration of Anti-CCP in RA patients that had Anti-CCP levels greater than normal was 95.1 IU/ml (range: 7.1-249 IU/ml). While mean concentration of Anti-CCP in RA patients that had Anti-CCP levels less than normal was 2.1 IU/m (range: 1.2-4.9 IU/ml).Controls had a mean Anti-CCP level of 7.35 IU/ml (range: 2.44-13.26 IU/ml)Diagnostic sensitivity and specificity of RF was reported as 81.7% and 44.6% respectively in the patients. Conclusion: As a screening method for rheumatoid arthritis IgM-RF, Anti-CCP antibody assays are superior to other RF isotypes assessments. Anti-CCP proved to be a powerful and specific diagnostic tool, especially in patients with undiagnosed rheumatoid arthritis.