Anti CCP and Anti MCV Antibodies in Rheumatological Disorders other than Rheumatoid Arthritis

Abstract

Anti-citrullinated protein antibodies (ACPA) have been reported as more specific serological markers of rheumatoid arthritis (RA). They provide a superior alternative to the rheumatoid factor (RF) test in laboratory diagnostics of RA (XIA et al., 2009). Different studies suggest that the enzymatic citrullination and the production of ACPAs may also be associated with other inflammatory arthritis-associated autoimmune diseases (Szodoray et al., 2009(. In systemic lupus erythematosus (SLE) arthritis is one of the most common symptoms, seen in 60–90% of patients. In the majority of cases of SLE, arthritis is nondeforming and nonerosive and thus will not directly cause irreversible functional impairment, thepresence of anti-CCP antibodies was strongly associated with erosive arthritis (Kakumanu, 2009(. In ourstudied SSc patients, Polyarthritis: have varied between 36-80%.Erosive arthritis have been reported throughout the MCP, PIP and DIP joints, as well as the wrist. Indeed, at 7 years of SSc, bony erosions (mostly in the hands) have been noted in 4 - 57% of patients (Clements et al., 2012). Aim of the workis to detect the presence of anti CCP and anti CMV antibodies in rheumatological disorders other than rheumatoid arthritis and its correlation to radiological findings and disease activity. In our study, anti CCP antibodies were found in 8 (11.4%) of SLE patients and 4 (13.3%) SSc patients, while anti MCV antibodies we found in 14 (20%) SLE patients and 8 (26.7%) of SSc patients.There is association between presence of anti CCP Abs and anti MCV Abs and a clinically evident arthritis in both SLE and systemic sclerosis. Strong relationship between high CRP level and a severe arthritis and joint erosions was noticed in lupus. A significant radiological evident bony erosions and synovial hypertrophy were found using ultrasonography and plain X-ray with seropositive Anti CCP in SLE and SS patients.In our study, cut off value of Anti CCP which was >12, with sensitivity of 70.42%, specificity of 60% positive predictive value of 80.6%, negative predictive value of 46.2% with diagnostic accuracy of 61.7%, and best cut off value of anti MCV which was >11, with sensitivity of 98.46%, specificity of 30%, positive predictive value of 75.3%, negative predictive value of 90% with diagnostic accuracy of 60.2% in other rheumatological diseases other than RA. And from that we concluded that there is a significant association between presence of anti CCP antibodies and anti MCV antibodies and the presence of evident arthritis either clinical or radiologically by using both x-ray and U/S in both SLE and systemic sclerosis patients.