Anti-Cyclic Citrullinated Peptide (CCP)

Rheumatic Disease Laboratory

Enzyme-linked immunosorbent assay

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Specimen Required:

Serum: Adult 2 mL,   Child 0.2 mL

nonhemolyzed, nonlipemic

Room temperature or 4°C

Days Test Set Up:

Once per week

Analytic Time:

48 hours

Reference Values:

Negative: <20 EU

Weakly Positive: 20-39 EU

Moderately Positive: 40-59 EU

Strongly Positive: >60 EU

CPT Code(s):

86200

Relevance:

CCP has proven to be superior to either anti-keratin antibody or rheumatoid factor (RF) testing in differentiating rheumatoid arthritis (RA) from other autoimmune diseases.

Notes:

The presence of CCP antibody occurs independently of elevated RF levels in patients with RA.

Reference(s)

• Schellekens GA, Visser H, de Jong BA, et al: The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide. Arthritis Rheum, 43:155-163, 2000.
• Bizzaro N, Mazzanti G, Tonutti E, et al: Diagnostic accuracy of the anti-citrulline antibody assay for rheumatoid arthritis. Clin Chem , 47:1089-1093, 2001.