Analysis of rheumatoid factor and anti-cyclic citrullinated peptide in individuals with rheumatalogical disorders attending a tertiary care hospital

Abstract

Introduction: Rheumatoid factor (RF) has been routinely used as a diagnostic test for rheumatoid arthritis (RA). RA should be diagnosed early to prevent joint injury before the damages become inevitable. Several new laboratory tests have also been used, the commonest of them being detection of antibodies to cyclic citrullinated peptides (anti-CCP or ACPA). For the diagnosis of individuals with rheumatoid arthritis and also for prognosis these two tests are universally performed. Antibodies produced against cyclic citrullinated peptide (ACPA) have a higher specificity with almost equal sensitivity when compared to Rheumatoid Factor. Hence we proceeded to analyse these two parameters’ in our Immunology laboratory. Aim: To analyse presence of Rheumatoid factor and ACPA in individuals with Rheumatalogical disorders. Materials and Methods: RF was tested qualitatively by using latex agglutination. Anti-CCP was tested using mono specific ELISA kit. Our study is a retrospective observational one, performed on analysis of the reports of the samples received and tested in the Immunology laboratory of a tertiary care hospital. 331 samples referred for testing both RF and ACPA during October 2018 to December 2018 were considered to analyse the correlation. Results: Out of 331 samples tested “18.1% of them were both RF and Anti-CCP positive, 9.3% were only Anti-CCP positive and RF negative, 5.4% were only RF positive and Anti-CCP negative and 67% were negative for both”. Conclusion: Anti-CCP is better than RF in terms of veracity of the diagnosis, and when both these are combined the diagnostic accuracy of RA is increased. Keywords: Rhematological disorders, Rheumatoid factor, Anti-CCP.