Anti-CCP: What a Weak Positive Result Means for You

Anti-CCP, or anti-cyclic citrullinated peptide antibodies, are autoantib

Hello Dr.
Gao,
Since the beginning of this year, I have been experiencing difficulty gripping with both hands upon waking up in the morning.
My fingers, wrists, and shoulder joints are painful, and sometimes I notice red, swollen lumps on my fingers and wrists.
In total, there are about 20 joints that are painful to varying degrees.
Initially, the immunologist tested my RA factor, which came back negative; however, they prescribed quinine without providing a specific diagnosis, only suggesting it might be vasculitis.
Later, the health insurance covered the anti-CCP test, and the doctor drew blood for it.
The result was weakly positive, but the doctor did not explain the significance of the weak positivity.
He mentioned that my anti-CCP value was 22, with a standard value of 20.

I would like to ask Dr.
Gao if an anti-CCP level of 22 can be interpreted.
Does this mean I need to undergo further testing? I am uncertain about my condition and am just taking medication, which makes me feel quite uneasy.
Thank you very much!

Xiao Ying, 30~39 year old female. Ask Date: 2013/07/19

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
A weakly positive anti-CCP refers to a value that is below three times the normal range, while a strongly positive result is above that threshold.
In the diagnosis of rheumatoid arthritis, the confirmation relies on the total score from various tests.
Both weakly and strongly positive anti-CCP and rheumatoid factor (RF) can serve as interpretive criteria, but they have different scoring values, which leads to variations in the overall diagnostic score calculation.
Your physician will test for anti-CCP, which suggests they suspect rheumatoid arthritis.
As for why they haven't informed you of a specific diagnosis, there may be reasons for that.
I recommend discussing your concerns with them; through patient inquiries, physicians can find opportunities for improvement and reflection.
After all, our accumulated experience comes from considering and learning from the various questions posed by patients.
The Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, cares about you.

Reply Date: 2013/07/19

More Info

Understanding a weak positive result for Anti-Cyclic Citrullinated Peptide (Anti-CCP) antibodies can be quite challenging, especially when experiencing symptoms like joint pain and swelling. Let's break down what a weak positive result means and its implications for your health.

Anti-CCP antibodies are often tested in the context of diagnosing rheumatoid arthritis (RA). A weak positive result, such as your value of 22 when the standard cutoff is 20, indicates that there is a presence of these antibodies, but it is not definitively high enough to confirm a diagnosis of RA on its own. The presence of Anti-CCP antibodies is more specific to RA than the rheumatoid factor (RF), which is why it is a valuable marker in the diagnostic process.

In your case, the fact that your RF was negative but you have a weak positive Anti-CCP result suggests that there may be an autoimmune process at play, but it does not conclusively diagnose you with RA. The symptoms you describe—difficulty gripping in the morning, pain in multiple joints, and swelling—are indeed consistent with inflammatory arthritis, which could be due to RA or another condition such as vasculitis, as your physician suggested.

It is essential to understand that a single test result is not sufficient for a diagnosis. Doctors typically consider a combination of clinical symptoms, physical examination findings, and laboratory results to arrive at a diagnosis. Since your Anti-CCP result is weakly positive, it may warrant further testing or monitoring over time. It is not uncommon for physicians to recommend follow-up testing to see if the antibody levels change, especially if your symptoms persist or worsen.

Regarding your concerns about not knowing what condition you have and being on medication, it is crucial to maintain open communication with your healthcare provider. If you feel uncertain or anxious about your diagnosis and treatment plan, do not hesitate to express these feelings to your doctor. They can provide clarity on the significance of your test results and the rationale behind your treatment.

In summary, a weak positive Anti-CCP result indicates the potential for an autoimmune process, but it is not definitive for rheumatoid arthritis. It is advisable to discuss with your physician the possibility of further testing and the need for ongoing monitoring of your symptoms. Your health and peace of mind are paramount, and understanding your condition is a vital part of managing it effectively.

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