I learned about anti CCP today

I do morning report on a regular basis. Sometimes I learn something completely new.

Today’s patient had bilateral knee, ankle and hand pain without synovitis. The patient also had new clubbing.

The resident told me that the anti CCP test was markedly positive. He could have been speaking a foreign language. He explained that anti CCP is a more sensitive and specific test for early RA. Rheumatologists are using this test to identify patients who need disease modifying agents prior to the development of deformities.

In our patient, the anti CCP was probably a false positive. It appears that the patient has hypertrophic osteoarthropathy secondary to an apparent lung cancer (biopsy pending).

The Use of Anti-cyclic Citrullinated Peptide (anti-CCP) Antibodies in RA

Several observations have indicated that anti-CCP positive early RA patients may develop a more erosive disease than those without anti-CCP (6). Other investigators have confirmed this, and suggested the superiority of anti-CCP over IgM RF in predicting an erosive disease course. The use of anti-CCP results in the decision whether a patient should be treated aggressively at an early stage or not is an important area for research. In addition, the relationship of levels of anti-CCP antibodies and various therapeutic interventions is under investigation.

I hope that this post helps someone else. I always get excited when I learn something truly new.