Estimation of Diagnostic markers in Rheumatoid Arthritis

Introduction:Rheumatoid arthritis (RA) is one of the most common rheumatoid disease with a significant level of morbidity. This chronic inflammatory disease affects nearly 0.5- 1% of adult population worldwide.The diagnosis of RA remains ambiguous and empirical, especially during the early course of the disease.Laboratory examination is a great value to confirm a diagnosis and estimate disease activity of Rheumatoid Arthritis.Since little researches related to the diagnosis of RA have been done in Iran, therefore, the aim of the present study was to evaluate the diagnosis markers in patients with RA. Methods:This cross-sectional study was conducted to evaluate the Rheumatoid factor (RF), anti-CCP,ESR and CRP levels in patients with RA,who were referred to the department of rheumatology during year 2016. Inform written consent was obtained from all enrolled patients prior to the study.Inclusion criteria were according to ACR criteria(American College of Rheumatology) and European League againstRheumatism (EULAR). A total of 103 patients with RA met inclusion criteria and were included in the present study population. Five ML blood samples were collected from patients.Rapid agglutination tests were performed for detection of RF and CRP,and anti-CCP were determined by enzyme linked immunoassay according to the manufacturer s protocol.Erythrocyte sedimentation rate (ESR) was determined by Westergen technique.Finally, statistical analysis test was conducted using spss software version 16.0. All results were expressed as mean ± standard deviation (SD) and categorical data were presented as percentages. Mann-whitney u test was used to compare statistical difference between RF positive and RF negative groups for ESR and anti-CCP levels.The chi-squared test was used to analyze categorical variables.Pvalue <0.05 were considered statistically significant. Results: The study patients with RA included 23 males (22.1%) and 81 females (77.9%) with average age of 50.25±14.34.In RA patients, 82.7% were RF positive and 17.3% were seronegative. Also,49% were CRP positive and 51% were negative. The mean ESR in RA patients was 27.76±20.17 mm/h and the mean levels of Anti-ccp were 109.15±90.55 IU/ml. A significant difference for Anti-ccp levels was observed between RF positive and RF negative groups,that anti-CCP levels were significantly higher in the RF positive group (p-value= 0.01). There is significant association between Anti-ccp levels and RF levels (p-value= 0.009).Conclusions:Based on the findings from this study and others,performing detection tests simultaneously may be useful for better diagnosis.Early diagnosis of the Rheumatoid arthritis can help to prevent complications and its progression and help patients to recover more quickly.

Keywords:

Rheumatoid Arthritis , ESR , CRP , Anti-CCP , Rheumatoid factor