The Association Between Anti-Cyclic Citrullinated Peptide and Anti-Mutated Citrullinated Vimentin and The Extra-articular Manifestations in Patients with Rheumatoid Arthritis

Background: Early detection of extra-articular symptoms (ExRA) in RA patients is crucial, and lifesaving. Aim: this study examined the relationship between Anti-Cyclic Citrullinated Peptide (Anti-CCP) and Anti-Mutated Citrullinated Vimentin (Anti-MCV) positivity and extra-articular symptoms in rheumatoid arthritis patients Patients and methods: The present investigation included 50 rheumatoid arthritis patients: 25 had extra-articular symptoms (group 1) and 25 did not (group 2). All patients underwent a complete history taking, clinical, and rheumatological assessment, followed by laboratory tests including anti-CCP/anti-MCV measurements. Results: As regard to anti-CCP, it ranged from 4 to 530 IU/ml; and there was no significant increase in group 1 when compared to group 2. On the other hand, anti-MCV ranged from 8 to 500 IU/ml; and there was statistically significant increase of anti-MCV in group 1 when compared to group 2 (272.44±117.61 vs 91.08±125.71 respectively). In diagnosing extra-articular manifestations, anti-CCP antibodies had lower predictability (0.72) than anti-MCV antibodies (0.85), which had higher sensitivity (96%), specificity (76%), and cut off point > 90 IU/ml. Conclusion: Rheumatoid arthritis patients with anti-MCV antibodies exhibited strong extra-articular manifestation predictors. Anti-CCP is a powerful diagnostic marker of rheumatoid arthritis, especially in early stages, but it had no significant connection with extra-articular symptoms.