Diagnosing Rheumatoid Arthritis
Citrulline Antibody Test
There is no singular test for diagnosing rheumatoid arthritis. The diagnosis is based on the clinical presentation. Ultimately, rheumatoid arthritis is diagnosed based on a combination of the presentation of the joints involved, characteristic joint swelling and stiffness in the morning, the presence of blood rheumatoid factor (RF test or RA test) and citrulline antibody, as well as findings of rheumatoid nodules and radiographic changes (X-ray testing). It is important to understand that there are many forms of joint disease that can mimic rheumatoid arthritis.
What is citrulline antibody?
Citrulline antibody is an immune protein (antibody) that binds to a nonstandard amino acid (citrulline) that is formed by removing amino groups from the natural amino acid, arginine. A chemical process known as citrullination causes this change to occur. Citrulline antibodies are measured with a blood (serum) test that is analyzed in laboratories. The test is also known as anti-citrulline antibody, cyclic citrullinated peptide antibody (CCPA), anti-cyclic citrullinated peptide antibody, and anti-CCP.
Research suggests that in the joints of patients with rheumatoid arthritis, proteins may be changed to citrulline as part of the process that leads to inflammation of the rheumatoid joint.
For what is citrulline antibody used?
Citrulline antibody is present in the blood of most patients with rheumatoid arthritis. It is used in the diagnosis of rheumatoid arthritis when evaluating patients with unexplained joint inflammation. A test for citrulline antibodies is most helpful in looking for the cause of previously undiagnosed inflammatory arthritis when the substance detected by the traditional blood test for rheumatoid arthritis, rheumatoid factor, is not present. Citrulline antibodies have been felt to represent the earlier stages of rheumatoid arthritis in this setting and may be positive when the rheumatoid factor (RF) test is negative.
The citrulline antibody test then can be used by doctors to encourage them to proceed with the optimal treatments directed toward rheumatoid arthritis. Research has found that the presence of citrulline antibodies has also been associated with a greater tendency toward more destructive forms of rheumatoid arthritis.
Medically Reviewed by a Doctor on 8/24/2016