| Abstract: |
New laboratory tests have appeared for the diagnosis and prognostic prediction of RA and other rheumatic diseases. Among them anti-CCP seems to be attracting the most attention. Because the operating utility of anti-CCP assay resides in distinguishing RA from other rheumatic disorders, we sought to assess the anti-CCP in a group of patients with a variety of these diseases including RA, polyarticular JRA, SLE, PR, OA AND FM. The aim of the work was to : (1) determine the diagnostic value of anti-CCP for early RA. (2) confirm the correlation of anti-CCP with treatment in patients with recent onset RA and its importance for the choice of the best therapeutic strategy. (3) detect clinical significance of anti-CCP antibodies in patients with PR, SLE, polyarticular JRA, OA and FM. (4) find the association of anti-CCP antibodies with progressive erosive or disabling disease. (5) evaluate the combination of anti-CCP with some other serologic markers as IgMRF and anti-ds DNA. Our study was conducted on 150 subjects divided into two groups, patient and control groups. Our results showed that anti-CCP alone is better than IgM-RF alone in diagnosis of early disease, but best results were achieved when they were combined. Also, there was significant difference between risky healthy relatives and healthy volunteers regarding anti-CCP, anti-ds DNA was specific for such patients and correlated with SLEDAI more than anti-CCP antibodies. We also found that anti-CCP declines with DMARDs treatment and low frequency of anti-CCP in non-inflammatory rheumatic disease (OA-FM). So, we recommend that the anti-CCP antibodies combined with IgM-RF should be evaluated for RA patients to early diagnose, predict the outcome and early treat RA., Anti-CCP antibodies should be evaluated in cases of early arthritis who are sernogative, in cases of PR and in risky individuals as relatives to RA patients, It should be evaluated during treatment to test the efficiency of the drug and choose the best therapeutic strategy. Anti-CCP combined with IgM-RF should be evaluated in polyarticular JRA patients for early diagnosis, predicting the outcome and early treatment. Anti-CCP can be evaluated to distinguish RA from erosive SLE and erosive OA. It can be evaluated to differentiate RA from other diseases and especially in patients with seropositivity.
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