AAMJ, Vol. 9, N. 1, January, 2011 ‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬

RELATIONSHIP BETWEEN ANTI-CYCLIC CITRULLINATED PEPTIDE ANTIBODIES AND DISEASE ACTIVITY AND EXTRAARTICULAR MANIFESTATIONS OF RHEUMATOID ARTHRITIS IN EGYPTIAN PATIENTS Hanan M Eltokhy*, Samia Taher Ali*, Samiha A Abd rabo*, Adeela M Gad*, Hind A El Sawi*, Nagwa Abd EL-Ghaffar**, Mohammed A Mansour***. Internal Medicine Department*, Faculty of Medicine For Girls, AL Azhar University, Clinical and Chemical Pathology Department**, National Research Center, Internal Medicine Department***, Military Medical Academy. -----------------------------------------------------------------------------------------------------SUMMARY Background: Rheumatoid arthritis (RA) is one of the most common systemic autoimmune diseases characterized by chronic persistent and progressive erosive polyarthritis, leading to irreversible joint disability and increased mortality. Questions are raised about the value of serological marker such as Anti-cyclic citrullinated peptide (Anti-CCP) antibody testing to diagnose RA earlier and make earlier treatment decisions possible. Anti-CCP may present before RA symptoms develop and can be used with rheumatoid factor to improve RA diagnosis. Aim of work: The aim of this study is to measure serum Anti-CCP antibody concentration among Egyptian patients with established rheumatoid arthritis in order to evaluate its diagnostic utility also to evaluate the relationship between plasma Anti-CCP (positivity & concentration) and presence of extra-articular manifestations and to assess its relationship to disease activity, disease severity as well as rheumatoid factor in rheumatoid arthritis patients. Subjects and Methods: Serum Anti-CCP antibody was estimated in 73 patients with established RA and 20 healthy subjects as control group. The patients were submitted to full history taking, clinical examination, and laboratory investigations including (liver function tests, blood glucose level, complete blood counts, kidney function tests, inflammatory markers, immunological profile and conventional radiology). Also all patients were assessed for clinical findings suggestive of any extra-articular manifestations and subsequently appropriate investigation applied according to the suspected extra-articular manifestation. Results: There was significant increase in mean serum level of Anti-CCP and RF antibodies in all established RA patients compared to control group (P