Does a positive anti-CCP test identify a distinct arthritis entity?
The introduction of tests recognizing 'anti-citrullinated protein antibodies' (ACPA) has caused a revolution in rheumatology. Immunization against citrullinated proteins is a feature almost unique for rheumatoid arthritis, although ACPA may occur long before the onset of symptoms. Even if the presence of ACPA does not seem to reveal a distinct arthritis phenotype at symptom onset, it predicts an aggressive disease course with unfavourable outcome. Despite the very high diagnostic specificity for rheumatoid arthritis, ACPA-positivity does not always accord with a traditional diagnosis of rheumatoid arthritis at clinical presentation. However, even when these patients are judged to suffer from mild undifferentiated arthritis, they call for follow-up and special attention by rheumatologists.
Skogh
Thomas
T
Division of Rheumatology/AIR, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University Hospital, Linköping, Sweden. thomas.skogh@lio.se
D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D018450:Disease Progression; D006801:Humans; D010456:Peptides, Cyclic / Q000276:immunology*; D012219:Rheumatology / Q000379:methods*
D001323:Autoantibodies; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide