Introduction: Rheumatoid arthritis (RA) is severe, progressive, systemic inflammatory disease of unknown aetiology. RA is diagnosed based on clinical features, biochemical parameters and radiological findings. Biochemical parameters used for diagnosis were Anti-CCP (anti cyclic citrullinated peptide) and RF (rheumatoid factor). Early diagnosis of RA will aid in reducing the disease progression.
Objective: To estimate the presence of both anti-CCP and RF and their association in RA.
Material and Methods: This was a prospective observational study conducted in department of clinical biochemistry in St John’s hospital from September 2018 to September 2019 after. Age group of the subjects was from 18- 60 years, diagnosed based on ECLIA method for Anti-CCP on Roche and nephelometry for RF, on MISPA-i2 systems. of both gender, diagnosed based on Anti-CCP and RF. 453 samples were included in the study. Additionally biochemical parameters CRP, AST, ALT, Hb, and ESR were also collected including Glucose. Sensitivity and specificity was also calculated for Anti CCP and RF.
Results: There were 112 female and 42 male in the study. On the basis of clinical evaluation and Serological evidence, 155 patients were diagnosed as cases of RA. Our results showed sensitivity of 80.5% and specificity of 100% for anti CCP, sensitivity of 86.1 % and specificity of 96.6% for RF. As per Operative Characteristic ROC curve analysis the cutoff for anti-CCP is <7.0 U/ml and RF is < 10.00 U /ml. Association with RF was tested using Fisher’s exact test with test statistics 3.5 and p=0.05. There is an association between Anti CCP and RF and a significant association between ages with RF positive samples.
Conclusion: There is a significant association between anti-CCP and RF in Rheumatoid arthritis patients. Female (72.7%) are more affected as compared to male (42%) in the age group of 41-50 years. Anti-CCP is an early marker and highly specific for detection of Rheumatoid arthritis, where as RF is sensitive in RA, Non-RA and Infections like HCV.
