ANTI CCP (ACCP)

Bone

Report in 4Hrs

At Home

No Fasting Required

Details

Diagnose rheumatoid arthritis (RA) early and with high specificity

₹549₹1,375

60% OFF

ANTI CCP (ACCP) - Comprehensive Medical Test Information Guide

Why is it done?
- Test Purpose: The Anti-CCP (Anti-Cyclic Citrullinated Peptide) test measures antibodies against cyclic citrullinated peptide, which are markers of autoimmune activity in rheumatoid arthritis (RA). This blood test detects specific autoantibodies that attack proteins in the body, helping to identify and diagnose RA at an early stage.
- Primary Indications for Testing:
  - Diagnosis of rheumatoid arthritis in patients with joint pain, swelling, and stiffness
  - Early detection of RA before significant joint damage occurs
  - Assessment of disease progression and severity
  - Risk stratification to predict aggressive disease course
  - Differentiation of RA from other arthropathies and autoimmune conditions
  - Monitoring treatment response in established RA
- Timing of Testing:
  - Typically ordered when patients present with symptoms suggestive of RA (joint pain, swelling, morning stiffness lasting >1 hour)
  - Often performed in the early stages of disease when treatment is most effective
  - Can be used for periodic monitoring throughout the disease course
Normal Range
- Reference Values:
  - Negative/Normal: <20 U/mL (or <20 AU/mL depending on laboratory)
  - Equivocal/Borderline: 20-39 U/mL
  - Positive/Elevated: ≥40 U/mL
- Unit of Measurement:
  - U/mL (Units per milliliter) or AU/mL (Arbitrary Units per milliliter) depending on the assay used
  - Reference ranges may vary slightly between different laboratory assays and methods
- Result Interpretation:
  - Negative Result: Absence of anti-CCP antibodies; low likelihood of RA, though early disease or seronegative RA cannot be completely excluded
  - Borderline Result: Weak positive; may require repeat testing or correlation with clinical symptoms and other laboratory findings
  - Positive Result: Presence of anti-CCP antibodies; strongly suggestive of RA or other autoimmune conditions; higher antibody levels correlate with more severe disease
- Clinical Significance:
  - Anti-CCP is more specific for RA than rheumatoid factor (RF); 95-98% specificity for RA diagnosis
  - Can be positive years before clinical symptoms appear (predictive value)
  - Remains positive regardless of disease activity; unlike some other markers, levels do not necessarily decrease with successful treatment
Interpretation
- Detailed Result Analysis:
  - Negative (<20 U/mL): No anti-CCP antibodies detected; may reduce suspicion for RA but does not completely exclude early disease, seronegative RA (5-10% of RA patients are seronegative), or other conditions
  - Low Positive (20-40 U/mL): Weak anti-CCP positivity; may warrant clinical correlation, repeat testing, and possibly consideration of other diagnostic modalities
  - Moderately Positive (40-100 U/mL): Moderate elevation indicating good probability of RA; warrants further investigation and potential initiation of disease-modifying antirheumatic drugs (DMARDs)
  - Highly Positive (>100 U/mL): High likelihood of RA; indicates potential for rapid disease progression and joint damage; suggests need for aggressive early intervention
- Factors Affecting Results:
  - Disease stage: May be negative in very early disease before antibody formation
  - Smoking: Increases risk of anti-CCP positivity and may worsen RA progression
  - Medications: Immunosuppressive drugs and DMARDs may not significantly lower anti-CCP levels despite clinical improvement
  - Other autoimmune conditions: May occasionally show low-level anti-CCP positivity in lupus, vasculitis, or other autoimmune diseases
  - Laboratory variability: Different assay methods may produce slightly different results; always compare with same laboratory reference range
- Clinical Significance Patterns:
  - Anti-CCP+ / RF+: Classic seropositive RA; high predictive value; more severe disease course expected
  - Anti-CCP+ / RF-: Anti-CCP alone positive; still indicative of RA; more specific than RF alone
  - Anti-CCP- / RF-: Seronegative RA; does not exclude RA diagnosis; clinical and imaging findings are more important
  - Persistently High Anti-CCP: Marker of chronic disease activity; may indicate need for treatment intensification
Associated Organs
- Primary Organ System Involved:
  - Musculoskeletal system (joints, cartilage, bone, synovial membrane)
  - Immune system (lymphocytes, antibody production)
- Diseases Diagnosed/Monitored:
  - Rheumatoid Arthritis (RA): Primary indication; one of the most specific markers
  - Early Inflammatory Arthritis (undifferentiated): Helps establish diagnosis in early stages
  - Anti-CCP Associated Systemic Manifestations: Extra-articular involvement including lung disease, vasculitis, cardiac complications
- Potential Complications with Abnormal Results:
  - Progressive joint destruction and deformity if disease is not treated early
  - Functional impairment and disability affecting quality of life and work capacity
  - Pulmonary complications: Rheumatoid lung disease, interstitial lung disease, increased infection risk
  - Cardiovascular involvement: Increased risk of myocardial infarction and atherosclerosis
  - Systemic vasculitis affecting multiple organ systems
  - Anemia and other hematologic complications secondary to chronic disease
  - Increased infection risk due to disease and immunosuppressive medications
Follow-up Tests
- Recommended Additional Diagnostic Tests:
  - Rheumatoid Factor (RF): Complementary test to confirm RA diagnosis; may be performed simultaneously with anti-CCP
  - Erythrocyte Sedimentation Rate (ESR): Measures inflammation; baseline and periodic monitoring
  - C-Reactive Protein (CRP): Acute phase reactant; sensitive indicator of disease activity
  - Complete Blood Count (CBC): Assess for anemia and thrombocytosis associated with RA
  - Comprehensive Metabolic Panel: Monitor kidney and liver function, especially if initiating DMARD therapy
  - Antinuclear Antibody (ANA): Rule out systemic lupus erythematosus or overlap syndromes
- Imaging and Clinical Assessment:
  - Hand and Wrist X-rays: Document baseline joint damage; establish severity of disease
  - Ultrasound: Detect early joint inflammation and erosions; more sensitive than X-ray
  - MRI: Evaluate soft tissue and early bone changes; useful for monitoring disease progression
  - Clinical Joint Assessment: Disease Activity Score 28 (DAS-28) or other validated scoring systems
- Screening for Extra-Articular Manifestations:
  - Chest X-ray: Screen for pulmonary involvement or infections
  - Pulmonary Function Tests (PFTs): Assess for rheumatoid lung disease if symptomatic
  - Electrocardiogram (ECG): Baseline assessment for cardiovascular status
  - Ophthalmologic examination: Screen for keratoconjunctivitis sicca and other ocular manifestations
- Monitoring Frequency:
  - Newly Diagnosed: Monthly laboratory monitoring for first 3 months to assess treatment response
  - Established Disease: Every 3-6 months during treatment; more frequently if adjusting medications
  - Remission/Low Activity: Every 6-12 months for continued monitoring
  - Anti-CCP Testing: Typically not repeated frequently as it remains stable; baseline value is most informative
Fasting Required?
- Fasting Requirement: NO
- Sample Collection Instructions:
  - Fasting is NOT required for anti-CCP testing
  - Blood sample can be collected at any time of day
  - May eat and drink normally before testing
  - No special dietary restrictions apply
- Specimen Type:
  - Serum (blood): 5-10 mL collected in a serum separator tube (SST) or standard collection tube
  - Allow blood to clot at room temperature for 30 minutes (if using SST)
  - Centrifuge to separate serum; refrigerate if not processed immediately
- Medications/Supplements to Avoid:
  - No specific medications need to be avoided before testing
  - Continue regular medications including DMARDs, corticosteroids, and NSAIDs as prescribed
  - Anti-CCP levels are not significantly affected by medications
- Additional Preparation:
  - Rest for 5-10 minutes before blood draw if possible
  - Inform phlebotomist of recent trauma, surgery, or active infection if applicable
  - Wear loose-fitting sleeves for easy blood draw access
  - Inform healthcare provider of any recent illnesses or infections, as these may transiently affect inflammatory markers

How our test process works!