Anti-CCP Test – Anti-Cyclic Citrullinated Peptide

What is Anti-CCP?

Anti-CCP or Anti-Cyclic Citrullinated Peptide is an autoantibody also known as ACPAs or anti-citrullinated protein antibodies. These antibodies are produced by the person’s immune system and identify the body’s tissue cells as foreign bodies and attack them.

Anti-CCP or ACPAs is a protein and is mostly found in the joints of patients who are suffering from rheumatoid arthritis. These antibodies can be present in the body of a patient for years even before he has started to develop the symptoms of rheumatoid arthritis.

What is Anti-CCP or ACCP test?

An Anti-CCP or ACCP test helps doctors to diagnose rheumatoid arthritis or RA. Earlier, another antibody test called the rheumatoid factor or RF was used to detect the disease. The ACCP test is relatively new and provides a more specific and accurate diagnosis and even earlier detection of the disease.

Since only 60 to 70% of the patients with RA will test positive with the Anti-CCP antibody, doctors may consider other factors and symptoms to detect the disease.

What is the importance of the Anti-CCP or ACCP test?

The Anti-CCP test is used to detect RA or rheumatoid arthritis. A positive Anti-CCP test is called seropositive rheumatoid arthritis and if it comes out negative, it is called seronegative rheumatoid arthritis.

-The test helps doctors to differentiate rheumatoid arthritis from other types of arthritis or joint diseases. The Anti-CCP antibody test helps to understand the severity of the disease.

– The test also helps in earlier detection of the disease followed by the commencement of the course of treatment which can control the disease at an early stage.

– The ACCP test is not associated with other autoimmune disorders and thus helps doctors to get a proper prognosis of rheumatoid arthritis disease.

The Anti-CCP test is important for several reasons such as:

– It helps to detect the aggressiveness of the disease.

– A positive ACCP test is a clear indication that an otherwise healthy person with no joint problems can develop rheumatoid arthritis in the future.

– Anti-CCP test helps to detect erosive diseases which cause the erosion of the bones which is a very severe condition.

When do I need an Anti-CCP or ACCP test?

Some certain distinct symptoms or signs will suggest rheumatoid arthritis. Your doctor may ask you to do an Anti-CCP test if you are exhibiting the following symptoms:

– Pain in the joints.
– Swelling in the joints, hands, and wrists.
– Pain in different parts of the body like shoulders, neck, hip, knees, feet, and elbows.
– Stiffness of the joints especially during the morning.
– Low Fever.
– Discomfort or pain while walking.
– Development of nodules especially under the skin at the elbows.
– Weight loss.
– Skin rashes.
– Deformity of the joints.

What can cause high Anti-CCP?

The exact reason for the development of the Anti-CCP antibody is still unknown. There are many factors that can be held responsible for this disease like:
 
– Environmental factors.
– Lung inflammation.
– Genetics
– Smoking

Anti-CCP positive patients are found to have a component called ‘shared epitope’, a common form of amino acids. The shared epitope attaches itself to human leukocyte antigen or HLA which is a protein and produces ACPAs.

How do I prepare myself for an Anti-CCP test?

The Anti-CCP test is a simple blood test and does not require any specific preparations. Individuals, however, need to inform their doctors if they are under any particular medication.

Do I need to fast before an Anti-CCP test?

No, you do not need to fast before an Anti-CCP test.

How is the Anti-CCP test done?

The Anti-CCP test is a normal blood test. A blood sample is collected from a vein of the upper part of your arm.

– The technician will clean a small patch of skin on your arm with an antiseptic solution.

– A tourniquet or an elastic band is tied around your arm.

– This swells up the veins and makes them more visible.

– The technician will then insert a needle attached to a vial or syringe to draw out the sample of blood.

– The blood is drawn and collected into a vial or syringe. The blood sample is then sent to a laboratory for further analysis.

How long will the test take to perform?

The test will only take a few minutes and you can then resume all your normal activities for the day.

When will I get my test results?

You will get your test result within a period of 24 to 36 hours.

What is the cost of the Anti-CCP test in India?

The average cost of Anti-CCP test in India can be anywhere between Rs 500 to Rs 3000 depending on the city, quality, and the laboratory conducting the test.

What is the normal range of Anti-CCP?

The normal range of Anti-CCP is less than 20 u/ml. If your test report suggests reading more than 20 u/ml, you are likely to be positive for rheumatoid arthritis.

What does a positive Anti-CCP test result mean?

If your test result comes out positive, you must immediately consult your orthopedic doctor. A positive test results in most of the cases is indicative of rheumatoid arthritis disease. The prognosis of the disease depends not only on your test result but also on specific signs and symptoms that you exhibit over a period of several weeks.

A positive Anti-CCP test result may indicate other medical conditions besides rheumatoid arthritis such as SLE or systemic lupus erythematosus.

What does a negative Anti-CCP test result mean?

A negative Anti-CCP test does not necessarily mean that you are not prone to the disease. Sometimes, you may get a negative test result, but still, display the symptoms of the disease. In such cases, you may have seronegative rheumatoid arthritis which may later develop into seropositive rheumatoid arthritis.

How will the Anti-CCP test help in diagnosing rheumatoid arthritis?

Anti-CCP tests are far more specific in diagnosing rheumatoid arthritis than RF tests. The results give much more accurate readings and rules out other autoimmune disorders. If your test results are positive, your doctor will do a physical examination to learn the symptoms of rheumatoid arthritis.

Your doctor will also order x-rays, CT scans, or magnetic imaging resonance scan or MR imaging to find out the degree of erosion of your bones. He will look for inflammation on your bones and joints and also do other blood tests along with the Anti-CCP test.

All these tests will help your doctor to rule out other types of arthritis and get a clear look at the presence of rheumatoid arthritis in your body.

How does the Anti-CCP test help in diagnosing JRA or Juvenile Rheumatoid Arthritis?

Juvenile rheumatoid arthritis or JRA can occur in young adults or children as young as two years. In such cases, the Anti-CCP test is used along with other tests like:
 
– CCP (Anti-Cyclic Citrullinated Peptide).
– ESR (Erythrocyte Sedimentation Rate).
– CRP (C-Reactive Protein).
– ANA (Antinuclear Antibody).

It is very difficult to detect JRA, especially in young children as they often ignore their symptoms and do not complain about pain or fatigue. Children often consider the symptoms to be normal and they can get undetected for years.

What are the symptoms of JRA?

Symptoms that indicate Juvenile Rheumatoid Arthritis are:

– Intermittent fever.
– Consistent swelling in the joints.
– Morning stiffness of joints.
– Unable to use an arm or leg.
– Diminished motor skills such as difficulty to hold something or dropping of objects.
– Discomfort or limping while walking.
– Reduced physical activity.

If your child is exhibiting some or all of the above symptoms, the doctor will do a physical examination of your child. He will order certain blood tests along with the Anti-CCP test to detect the disease. The doctor will also look for any family history of rheumatoid arthritis to detect the likelihood of the disease. In severe cases, a child’s growth may also be hampered due to the inadequate growth of bones and joints.