Romatoit Artrit Öntanılı Hasta Serumlarında Anti CCP ve RF ‘ün Değerlendirilmesi

Abstract

Romatoid artrit (RA), tendon kılıfı ve eklemlerde inflamasyon, ağrı ve kas zayıflıkları ile karakterize, kronik ve inflamatuar bir hastalıktır. Bu çalışmada İzmir Katip Çelebi Üniversitesi Atatürk Eğitim ve Araştırma Hastanesi Tıbbi Mikrobiyoloji Laboratuarına Romatoit artrit ön tanısıyla gelen hastalarda anti CCP ve RF'ün birbiri ve tanıya yardımcın testler (CRP, WBC, PLT ve Sedimentasyon) ile ilişkisnin değerlendirilmesi amaçlanmıştır. Ocak 2017-Ağustos 2018 tarihleri arasında RA öntanısıyla gönderilen toplam 5399 hasta çalışmaya dahil edilmiştir. Anti CCP düzeyleri Enzim Immunoassay metodu ile ORGENTEC diagnostica GMBH marka kit kullanılarak Allegria cihazında, RF düzeyleri ise Türbidimetrik metodu ile Abbott Architect C16000 cihazında üretici firmanın talimatları doğrultusunda araştırıldı. Anti CCP 498(%9.2) hastada RF ise 4213(%78) hastada pozitif çıkmıştır. Anti-CCP pozitif olan 498 hastanın 43(%8,6)’ünde RF negatif bulunmuştur. RF pozitif bulunan 4213 hastanın 3758(%89,2)’inde anti CCP negatif bulunmuştur. Anti CCP değerleri ile RF, PLT ve sedimentasyon ve RF ise WBC, PLT ve sedimentasyon ile anlamlı bir korelasyon saptanmıştır. Anti-CCP ayrıca yüksek spesifitesi nedeniyle RA’yı diğer RF pozitif olabilen artrit formlarından da ayırt etmede kullanılabilir. Çalışmamızda RA’li hastaların bir bölümünde RF negatif olup anti-CCP pozitif sonuç vermiştir, bundan dolayı seronegatif RA’li hastalarda RA tanısını koymada fayda sağlamaktadır. RA hastalarında sedimentasyon yüksekliği tanıyı desteklerken, CRP testinin yararı sınırlı bulunmuştur.

Evaluation of Anti-CCP and RF in pre-diagnosed Patient Serums of Rheumatoid Arthritis

Abstract

Rheumatoid arthritis (RA) is a chronic and inflammatory disease characterized by inflammation, pain and muscle weakness in the tendon sheath and joints. In this study, it was aimed to evaluate the relationship of anti-CCP and RF values with each other and with other diagnostic assisting test results (CRP, WBC, PLT, and Sedimentation) in patients who have been pre-diagnosed with rheumatoid arthritis in Izmir Katip Çelebi University Atatürk Training and Research Hospital Medical Microbiology Laboratory. A total of 5399 patients who have pre-diagnosed as RA between January 2017 and August 2018 were included in the study. Anti-CCP levels were investigated with the Enzyme Immunoassay method by using the ORGENTEC Diagnostica GMBH kit via the Alegria instrument. The RF levels were investigated with the Turbidimetric method by Abbott Architect C16000 instrument according to the manufacturer's instructions. Anti-CCP was positive in 498 (9.2%) patients and RF positive in 4213 (78%) patients. RF was found to be negative in 43 (8.6%) of 498 patients identified as anti-CCP positive. In addition, anti-CCP was negative in 3758 (89.2%) of 4213 patients who were identified as RF positive. A significant correlation was found between anti-CCP values and RF, PLT, and sedimentation values, and between RF values and WBC, PLT and sedimentation values. In addition, Anti-CCP can be used to distinguish RA from other RF positive arthritis forms due to its high specificity. In our study, RF was determined as negative in some of the patients diagnosed with RA, while anti-CCP was determined as positive. Therefore, it helps to diagnose RA in patients with seronegative RA. While the increase in the sedimentation values in RA patients supports the diagnosis, the benefit of the CRP test was found to be limited.

Keywords

• Anti CCP
• Romatoid artrit (RA)
• RF
• CRP
• sedimentasyon

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