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Use of serological markers for evaluation patients with rheumatoid arthritis

Authors:Ali Alghuweri, Ahmed Marafi, Mansour Alhiary
Int J Biol Med Res. 2012; 3(1): 1397-1398  |  PDF File


Abstract Objective: The aim of this study was to determine the frequency of antinuclear antibody, rheumatoid factor, and cyclic citrullinated peptide antibody in patients with rheumatoid arthritis and to compare cyclic citrullinated peptide antibody with rheumatoid factor. Methods: Our study was conducted in princess Iman Center for research and laboratory sciences at King Hussein Medical Center in a period from August 2011 to November 2011. In this study 115 patients from arthritis clinic were examined. For all we measured the antinuclear antibody (indirect immunofluorescence), cyclic-citrullinated peptide (enzyme linked immunosorbent assay), rheumatoid factor (agglutination assay). Results: Out of 115 patients with arthritis, 97 were females and 18 were males. Median age was 57.5 years for males and 48.5 years for females. 60% (69) of patients were positive for antinuclear antibody. 55% (64) of patients were positive for three serological markers (cyclic-citrullinated peptide antibody, antinuclear antibody and rheumatoid factor). For these patients further investigations were done such as dsDNA and extractable nuclear antibody (ENA), and were negative for both. Only 5 patients of 115 were positive for antinuclear antibody alone with speckled pattern, of them 4 had high titer(> 1/160) and positive for ENA and 1 had low titer (1/80) and negative for ENA. The incidence of cyclic-citrullinated peptide antibody and rheumatoid factor was 79.1 %( 91) and 81.7 %( 94) respectively. 23.4% (27) of patients had positive for both serological markers (anti-ccp and RF). Conclusion: For evaluation patients with suspected rheumatoid arthritis recommended perform cyclic-citrullinated peptide antibody and IgM- rheumatoid factor. The results of both tests are informative, since a positive result for either test increase diagnostic sensitivity, while the specificity is increased when both tests are positive.