抗突变型瓜氨酸波形蛋白抗体在类风湿关节炎诊断中的意义

目的了解抗突变型瓜氨酸波形蛋白(MCV)抗体在类风湿关节炎(RA)诊断中的意义,并比较抗MCV抗体与类风湿因子(RF)、抗核周因子(APF)、抗角蛋白抗体(AKA)、抗环瓜氨酸多肽(CCP)抗体以及某些临床指标的相关性。方法对166例研究对象,包括74例RA患者(其中早期18例,中晚期56例),50例非RA的风湿性疾病患者,42名健康对照,应用酶联免疫吸附试验(ELISA)检测血清中的抗MCV抗体,同时检测其他相关自身抗体,结合临床资料进行分析。结果74例RA中抗MCV抗体阳性58例,对RA诊断的敏感性为78％,特异性为95％,阳性预测值和阴性预测值分别为97％和71％。抗MCV抗体阳性的平均抗体浓度依次为(552±380)U/ml(RA组),(162±63)U/ml(非RA组),(63±46)U/ml (健康对照组)。RA组的平均抗体水平较高。抗MCV抗体和抗CCP抗体相关性最强(r=0．502,P=0．000),APF、AKA次之(r=0．369、0．408,P＜0．01)。抗MCV抗体与各项临床、实验室指标间的差异无统计学意义(P＞0．05)。结论抗MCV抗体在RA中具有较高的敏感性和特异性,且较APE、AKA与抗CCP抗体相关性强,可作为RA诊断的辅助指标。抗MCV抗体可能与病情活动度、功能状态无关。     

63例类风湿关节炎患者抗MCV抗体检测及分析

目的探讨抗突变型瓜氨酸波形蛋白(MCV)抗体检测在类风湿关节炎(RA)诊断中的临床意义。方法选择RA患者(RA组)、其他自身免疫病患者(AD组)、健康查体者(对照组)各63例,均采用ELISA法定量检测抗MCV抗体和抗环瓜氨酸肽(CCP)抗体,用速率散射免疫比浊法检测类风湿因子(RF)-IgM,用四格表计算抗MCV抗体、抗CCP抗体和RF-IgM诊断RA的敏感性、特异性、阳性预测值及阴性预测值。结果 RA组抗MCV抗体、抗CCP抗体与RF-IgM阳性率均显著高于AD组和对照组(P均<0.01);抗MCV抗体的诊断敏感性和特异性均显著高于RF-IgM(P均<0.05),其中敏感性显著高于抗CCP抗体(P<0.05);抗MCV抗体诊断RA的阳性预测值和阴性预测值均略高于抗CCP抗体及RF-IgM(P均>0.05)。结论抗MCV抗体对RA有较高的诊断价值,且检测方法简便、快捷,可作为筛查和辅助诊断RA的重要指标。     

抗CCP、抗RA33和RF在类风湿关节炎诊断中的作用

目的探讨抗环瓜氨酸肽抗体（anti-ccp）、抗RA33抗体和类风湿因子对类风湿关节炎（RA）的诊断意义.方法对RA（104例）和其他风湿性疾病患者（75例）,以及健康成人（40例）的血清进行检测,应用ELISA法检测抗CCP抗体和抗RA33抗体,乳胶凝集法检测RF.结果抗CCP对RA诊断敏感性56.7%,特异性100%;抗RA33对RA诊断的敏感性28.8%,特异性90.7%;RF对RA诊断的敏感性72%,特异性62.7%;RF与抗CCP和抗RA33同时检测敏感性提高到84.6%,特异性提高到100%.37.9%和17.2%RF阴性的RA患者分别有抗CCP和抗RA33阳性.结论抗CCP和抗RA33对RA诊断特异性优于RF（P＜0.05）,三者同时检测是RA较理想的血清学诊断方法.     

类风湿关节炎患者抗CCP抗体检测及与其他实验室指标的关系

目的探讨抗环瓜氨酸肽抗体（抗CCP抗体）在类风湿关节炎（RA）中的诊断价值。方法选择RA患者116例、其他自身免疫病患者79例、健康对照者50例,采用ELISA法行抗CCP抗体检测,并检测RA患者的相关实验室指标。结果抗CCP抗体诊断特异性（94.58%）高于类风湿因子（RF）（68.22%）。进行抗CCP抗体、RF联合检测时,以任一项指标阳性的敏感性高于两者均阳性的敏感性（P〈0.05）。抗CCP抗体阳性的RA患者C反应蛋白（CRP）、血沉（ESR）均高于阴性者（P〈0.01）。结论抗CCP抗体在RA诊断中具有较高特异性,以抗CCP抗体或RF任一种阳性为诊断指标有利于早期诊断RA。抗CCP抗体阳性可能与RA活动性相关。     

抗环瓜氨酸多肽抗体检测早期诊断类风湿关节炎研究

目的探讨抗环瓜氨酸多肽(CCP)抗体检测对类风湿关节炎(RA)早期诊断的意义。方法应用ELISA法检测2004—2005年中国医科大学附属盛京医院150份人血清的抗CCP抗体,包括54例RA患者,80例其它风湿病患者,16名正常人;并分析抗CCP抗体与类风湿因子(RF)、C反应蛋白(CRP)、血沉(ESR)的相关性。结果抗CCP抗体对RA的敏感性和特异性分别为70·4%和93·8%。发病2年内与2年以上的抗CCP抗体阳性率差异无显著性。抗CCP抗体阴性组与阳性组的关节畸形率差异无显著性。抗CCP抗体与RF、CRP、ESR无相关性。结论抗CCP抗体对RA具有较好的敏感性和很高的特异性,联合抗CCP抗体和RF可以提高诊断的准确性,对RA的早期诊断具有重要意义。     

血清抗CCP抗体、抗RA33抗体在类风湿关节炎诊断中的价值

检测75例类风湿关节炎(RA)患者(RA组)、54例非RA风湿病患者(非RA组)及40例健康人(对照组)血清中抗环瓜氨酸肽(CCP)抗体(简称抗CCP)、抗RA33抗体(简称抗RA33)水平,并与类风湿因子(RF)比较.结果RA组抗CCP、抗RA33和RF的阳性率及滴度均明显高于其他两组;抗CCP、抗RA33对RA的敏感性较RF低,特异性较RF高.抗CCP与RF诊断一致性好,抗RA33与RF诊断一致性差.认为抗CCP和抗RA33有助于不典型RA(特别是RF阴性的RA)的诊断,在一定程度上可弥补RF对RA诊断不足.三种抗体联合检测可提高RA的诊断率.     

抗突变型瓜氨酸波形蛋白抗体葡萄糖-6-磷酸异构酶和抗环瓜氨酸多肽抗体检测在类风湿关节炎诊断中的价值

目的 了解抗突变型瓜氨酸波形蛋白(MCV)抗体、葡萄糖-6-磷酸异构酶(GPI)、抗环瓜氨酸多肽(CCP)抗体检测在类风湿关节炎(RA)诊断中的价值.方法 检测109例RA患者,24例其他风湿病患者及19名健康对照血清中抗MCV抗体、GPI和抗CCP抗体,比较3种抗体单独或联合检测对诊断RA的敏感性和特异性.结果 RA组抗MCV抗体和GPI阳性率及平均浓度显著高于其他风湿病组及健康对照组(P<0.05).抗CCP抗体与GPI阳性率在RA患者中的差异有统计学意义.抗MCV抗体对RA敏感性最高(99.1%);抗CCP抗体对RA特异性最高(90.7%);联合检测以MCV+CCP、MCV+GPI以及MCV+CCP+GPI特异件最高(均为98.1%).结论 单独或联合检测抗MCV抗体、抗CCP抗体和GPI,有助于提高RA诊断的敏感性和特异性.     

血清抗角蛋白抗体抗环瓜氨酸肽抗体和类风湿因子在类风湿关节炎中的意义

目的 评价抗角蛋白抗体(AKA)、抗环瓜氨酸肽(CCP)抗体和类风湿因子(RF)在类风湿关节炎(RA)中的意义.方法 收集82例RA患者及56例非RA患者,测定其抗CCP抗体、AKA和RF水平,评价对RA诊断的敏感性、特异性,比较RA患者中抗CCP抗体、AKA阳性组和阴性组的压痛关节数、肿胀关节数、红细胞沉降率(ESR)、C反应蛋白(CRP)、疾病活动指数(DAS)、Ritchie's指数(RAI).结果 单独检测AKA、抗CCP抗体、RF及联合检测的曲线下面积都较高(P<0.05).抗CCP抗体、AKA的特异度分别为92.9%、91.1%,联合检测AKA、抗CCP抗体和RF有任何一种及以上阳性的灵敏度最高,为95.1%.抗CCP抗体阳性组与阴性组的关节肿胀数、关节压痛数、ESR、CRP、DAS、RAI差异有统计学意义(P<0.05);AKA阳性组与阴性组的关节肿胀数、ESR、DSA差异均有统计学意义(P<0.05).结论 联合检测抗CCP抗体、RF、AKA对诊断RA有意义,抗CCP抗体、AKA可能与RA的活动度相关.     

抗突变型瓜氨酸化波形蛋白抗体检测在类风湿关节炎中的意义

目的 评价抗突变型瓜氨酸化波形蛋白（MCV）抗体在类风湿关节炎（RA）诊断中的价值。方法 检测136例RA患者，80例其他结缔组织病患者以及19名正常对照血清中抗MCV抗体的分布，比较抗MCV抗体与类风湿因子（RF）、抗环瓜氨酸肽（CCP）抗体和抗角蛋白抗体（AKA）的相关性，并分析上述抗体在RA诊断中的意义。结果 136例RA患者抗MCV抗体敏感性和特异性分别为95．6％和80．8％．与非RA对照组比较差异有统计学意义（P〈0．05）。抗MCV抗体与抗CCP抗体、AKA和RF的重叠阳性率分别为91．9％、52．8％和76．5％。经统计学分析，抗MCV抗体与抗CCP抗体、AKA和RF之间存在相关性。结论 抗MCV抗体对RA有较高的诊断价值，可视为RA新的血清学诊断指标．能提高RA的早期诊断率。     

抗环瓜氨酸肽抗体在类风湿关节炎中的意义

目的探讨抗环瓜氨酸肽(CCP)抗体在类风湿关节炎(RA)诊断治疗中的意义。方法采用酶联免疫吸附试验(ELISA)法分别测定40例RA患者、56例其他风湿病患者的抗CCP抗体、类风湿因子IgM-RF、IgG-RF及类风湿因子(RF),同时比较20例RA患者治疗前后抗CCP抗体的水平变化。结果(1)RA组的抗CCP抗体水平显著高于其他风湿病组(P<0.01),抗CCP抗体对RA的敏感性和特异性分别为80%、85.7%,与RF比较其特异性、阳性预测值之间差异有显著性(P均<0.05)。(2)抗CCP抗体与IgM-RF、IgG-RF联合检测中,二项联合检测的特异性为96.4%,三项联合检测的特异性为98.2%,与单独检测抗CCP抗体、RF有更高的特异性。(3)20例RA患者治疗后抗CCP抗体水平显著下降(P<0.05)。结论抗CCP抗体对RA诊断具有良好的敏感性和特异性,可用于RA的临床诊断。抗CCP抗体与IgM-RF、IgG-RF联合检测可提高RA的早期诊断率。抗CCP抗体还可作为临床活动指标之一。     

Clinical evaluation of anti-mutated citrullinated vimentin by ELISA in rheumatoid arthritis

OBJECTIVE: Anti-cyclic citrullinated peptide (CCP) antibodies have emerged as sensitive and specific serological markers of rheumatoid arthritis (RA). However, antibodies to several other citrulline-containing proteins, including citrullinated fibrin and vimentin, have been detected in patients with RA, suggesting that citrulline is an essential constituent of autoantigens for RA-specific autoantibodies. We examined the diagnostic performance of the newly developed anti-mutated citrullinated vimentin (MCV) antibody assay. METHODS: Concentrations of anti-MCV, anti-CCP2, and rheumatoid factors (RF) were determined in the sera of 237 individuals: 119 patients with RA and 118 controls, including patients with other rheumatic diseases and healthy subjects. Diagnostic properties were compared by receiver-operating characteristic curve analysis. RESULTS: Using manufacturer's recommended cutoff values, sensitivity and specificity of anti-MCV antibodies were 75.6% and 91.5% in RA, compared to 66.4% and 98.3% for anti-CCP2. Introducing cutoff values to obtain the same 95% specificity resulted in decreased sensitivity of the anti-MCV test (69.7%) and increased sensitivity of the anti-CCP2 test (74.8%). At optimal cutoff levels, 29.4% of IgM RF-negative cases as well as 13.3% of anti-CCP2-negative cases in the RA group were anti-MCV-positive. Double-positivity for anti-MCV and anti-CCP2 provided 98.3% specificity with 97.5% positive predictive value in RA. CONCLUSION: Overall, the performance of the novel anti-MCV ELISA for the diagnosis of RA is similar to that of the anti-CCP2 test [area under the curve 0.853 (95% CI 0.801-0.905) vs 0.910 (95% CI 0.873-0.946); p not significant]. As the diagnostic spectrum of the anti-MCV assay is somewhat different from that of anti-CCP2, the combined application of the 2 assays can improve the laboratory diagnostics of RA.     

白细胞介素-33的测定及其与早期类风湿关节炎相关性的研究

目的 通过检测早期类风湿关节炎(RA)患者血清中的白细胞介素(IL)-33水平,分析其与早期RA之间的相关性.方法 收集病程<1年的早期RA患者100例,骨关节炎(OA)患者40例以及健康对照者70名.采用双抗体夹心酶联免疫吸附试验(ELISA)测定血清中的IL-33水平,并分析血清IL-33水平与RA各临床和实验室指标的相关性.计量资料的比较采用Kruskal-Wallis检验和(或)Mann-Whitney U检验,计数资料比较采用X2检验,相关性分析采用Spearman相关分析.结果 RA患者血清IL-33水平为(282±871)pg/ml,显著高于健康对照组[(7±38)pg/ml,P(0.01)和OA患者[(8±35)pg/ml,P<0.01].血清IL-33水平与类风湿因子(RF)、隐性类风湿因子IgG(HRF-IgG)、抗环瓜氨酸肽(CCP)抗体、抗突变型瓜氨酸化波形蛋白(MCV)抗体呈正相关(r分别为:0.312,0.277,0.213,0.302,P<0.01或P<0.05). IL-33阳性组患者的RF阳性率、HRF-IgG阳性率、抗CCP抗体阳性率、抗MCV抗体阳性率(86%、31%、86%、94%)较IL-33阴性组患者(54%、11%、42%、72%)显著升高(P均<0.05). 结论 IL-33在RA患者血清中显著升高,并与多种自身抗体(包括RF、抗CCP抗体、抗MCV抗体和HRF-IgG)显著相关,可能是RA预后不良的因素之一.     

Antibodies targeting mutated citrullinated vimentin in patients with psoriatic arthritis

Antibodies against mutated citrullinated vimentin (anti-MCV) are of a comparable diagnostic value in rheumatoid arthritis (RA) as antibodies targeting citrullinated peptides (anti-CCP). Anti-CCP are present in up to 15% of psoriatic arthritis (PsA) patients, while the prevalence of anti-MCV in PsA patients has been poorly investigated. The aim of the present study was to assess the prevalence and relevance of anti-MCV antibodies in PsA patients. The study included 56 PsA patients. Clinical features, disease activity, and functional ability were noted by an experienced rheumatologist. Serum samples of all patients were analyzed for anti-MCV and anti-CCP antibodies using enzyme-linked immunosorbent assay. Data on 92 patients with RA, 44 patients with other inflammatory rheumatic diseases, and 107 healthy controls from a previous study were used to compare the prevalence of anti-MCV antibodies in PsA patients. Anti-MCV antibodies were positive in only two out of 56 (3.6%) PsA patients, which was significantly lower compared to RA patients (63%). The anti-MCV level was moderately positive and borderline in one patient each. Both patients had asymmetric polyarthritis, dactylitis, moderate to high disease activity, and were anti-CCP and rheumatoid factor (RF) negative. There was no significant difference in anti-MCV levels according to clinical subtypes of PsA and no correlation of anti-MCV levels with anti-CCP, RF, disease activity variables, and functional ability indices. According to study results, anti-MCV antibodies can be detected in a very small proportion of PsA patients with polyarthritic disease and are primarily related to the polyarthritic pattern rather than the specific diagnosis of RA.     

Antibody against mutated citrullinated vimentin: a new sensitive marker in the diagnosis of rheumatoid arthritis

The aim of this study was to determine the performance of antibodies against mutated citrullinated vimentin (anti-MCV) in comparison with antibodies to cyclic citrullinated peptides (anti-CCP) in patients with rheumatoid arthritis (RA). Serum levels of anti-MCV and anti-CCP were determined in 193 patients with RA and 332 controls, and sensitivity and specificity were calculated. In a separate analysis of 86 patients, the anti-MCV levels were compared to disease activity. Sensitivity of anti-MCV versus anti-CCP was 71.5 and 69.4%, specificity was 81.3 and 97.6%, respectively. The ROC curves showed higher specificity and an advantage of anti-CCP. In seronegative RA patients the sensitivity of anti-MCV was superior over anti-CCP. Anti-MCV positivities also occurred in systemic lupus erythematosus and Sjoegren’s syndrome. In a subgroup of 86 RA patients we found a significant correlation between anti-MCV and disease activity. Anti-MCV appears to be an important marker for the diagnosis of RA, and correlates also with disease activity.     

Anti-MCV antibodies predict radiographic progression in Greek patients with very early (&lt;3 months duration) rheumatoid arthritis

This study aimed to assess the diagnostic and prognostic value of anti-mutated citrullinated vimentin (MCV) antibodies in very early rheumatoid arthritis (VERA) and in established rheumatoid arthritis (RA). Seventy-one patients with undifferentiated arthritis (UA) of <3 months duration, 141 with established RA, 53 with other rheumatic diseases, and 40 healthy individuals were included in the study. Anti-MCV, anti-cyclic citrullinated peptide (CCP) antibodies, and rheumatoid factor (RF) were determined and hand radiographs were recorded. Patients were assessed prospectively for 2 years, and hand radiographs were repeated. Diagnostic performance of anti-MCV was studied with receiver operating characteristic (ROC) curves and evaluation of sensitivity, specificity, and likelihood ratios. Forty-six percent of UA patients progressed to RA at 2 years. In VERA patients, sensitivity of anti-MCV was 52 %, compared to 44 % of anti-CCP and 37 % of RF, while specificity was 91 %, compared to 91 % of RF and 84 % of anti-CCP. Anti-MCV were detected in 25 % of VERA patients negative for both anti-CCP and RF. In established RA, anti-MCV did not sustain its diagnostic performance. By multivariable analysis, anti-MCV, but not anti-CCP or RF, showed significant correlation with radiographic progression in VERA patients. In established RA, anti-MCV, anti-CCP, and RF were associated with active disease (p ≤ 0.03) and joint damage (p ≤ 0.004). By multivariate analysis, the strongest factors for radiographic damage were disease duration (p = 0.000), HAQ score (p = 0.000), and RF (p = 0.002). In conclusion, in patients with very early UA, anti-MCV predict both progression to RA and radiological damage, and therefore, anti-MCV antibody testing may be useful in every day practice.     

Clinical utility of the anti-CCP assay in patients with rheumatic diseases

OBJECTIVES: To determine the frequency of antibodies to cyclic citrullinated peptides (CCP) in a group of patients with a diversity of rheumatic diseases. METHODS: 249 consecutive sera from an arthritis clinic sent for rheumatology testing were selected for testing with the anti-CCP2 assays and for the presence of rheumatoid factor (RF). Patient charts were reviewed for demographic information, clinical diagnosis, radiographic information, and other laboratory data. RESULTS: The sensitivity and specificity of anti-CCP reactivity for the diagnosis of rheumatoid arthritis (RA) were 66.0% and 90.4%, respectively. This compared with the sensitivity and specificity of RF for RA at 71.6% and 80.3%. Furthermore, 10/29 (34%) RF- patients with RA demonstrated reactivity to CCP. The presence of either anti-CCP or RF increased testing sensitivity for diagnosis of RA to 81.4%; the presence of both RF and anti-CCP demonstrated a testing specificity similar to that of anti-CCP reactivity alone for the diagnosis of RA (91.1%). CONCLUSIONS: The detection of anti-CCP is useful for the diagnosis of RA, in fact even more so than RF, because of its higher specificity.     

抗环瓜氨酸肽抗体检测在类风湿关节炎中的诊断及预后意义探讨

目的 评价抗环瓜氨酸肽(CCP)抗体和类风湿因子(RF)在鉴别类风湿关节炎(RA)和其他风湿性疾病中的意义．探讨RA骨侵蚀与上述两种抗体之间的相关性。方法采用横断面研究，在125例RA．56例其他风湿性疾病，55例非风湿性疾病中检测上述两种抗体，其中抗CCP抗体采用酶联免疫吸附试验(ELISA)法．IgM-RF采用速率比浊法。分析RA骨侵蚀与上述两种抗体之间的相关性。结果IgM-RF诊断RA的敏感性较抗CCP抗体高(RF58．4％，抗CCP抗体54．4％)(P=0．57)；但抗CCP抗体有更高的诊断特异性(抗CCP抗体94．6％，IgM-RF84．7％)(P=0．015)，且两种检测方法之间无相关性。联合检测抗CCP抗体和IgM-RF有很高的特异性98．2％．较单独检测IgM-RF有更高的阳性预测值(PPV)95．7％(P=0.019)．阴性预测值(NPV)有下降57.7％(P=-0.213)。抗CCP抗体阳性、IgM-RF阳性与RA骨侵蚀相关。结论抗CCP抗体与IgM-RF比较对RA有良好的诊断敏感性与特异性．可视为RA新的血清学诊断指标。抗CCP抗体与RA骨侵蚀的关系值得进一步研究。     

Antibodies against citrullinated vimentin in rheumatoid arthritis: higher sensitivity and extended prognostic value concerning future radiographic progression as compared with antibodies against cyclic citrullinated peptides

OBJECTIVE: The Sa autoantigen can be found in inflamed synovium of patients with rheumatoid arthritis (RA), and at least part of the humoral RA-specific anti-Sa response is directed against citrullinated vimentin. This study was undertaken to evaluate the sensitivity, specificity, and prognostic value of determination of levels of antibodies against modified citrullinated vimentin (anti-MCV) as compared with antibodies against cyclic citrullinated peptides (anti-CCP) in an inception cohort of patients with early RA. METHODS: Clinical data, radiographs, and measurements of levels of anti-MCV and anti-CCP antibodies were obtained in 273 patients with early RA at baseline, after 3 months, and after 1, 2, 3, and 5 years. Autoantibodies were also analyzed in 100 healthy controls. RESULTS: Of the 273 patients, 193 (70.7%) were anti-MCV positive and 158 (57.9%) were anti-CCP positive at the time of diagnosis, with nearly equal specificities (95% and 96%, respectively). Forty (14.7%) were anti-MCV positive only, and 5 (1.8%) were anti-CCP positive only. Anti-MCV-positive and anti-MCV-negative patients had similar disease activity at baseline, but presence of anti-MCV was predictive of subsequent high disease activity and continued radiographic progression. Changes in anti-MCV level showed stronger correlation with changes in clinical parameters than did changes in anti-CCP level. The subgroup of patients who were anti-MCV positive and anti-CCP negative showed a higher rate of radiographic destruction than did patients who were negative for both anti-MCV and anti-CCP. CONCLUSION: These findings show that when patients with early RA are compared with healthy controls, analysis of anti-MCV yields greater sensitivity and unchanged specificity as compared with analysis of anti-CCP. Anti-MCV also appears to perform better than anti-CCP in identifying poor radiographic prognosis in patients with early RA.     

Antibodies to citrullinated peptides in tuberculosis

Rheumatoid arthritis (RA) is an autoimmune disease characterized by symmetric polyarthritis, rheumatoid factor (RF) positivity, and bone erosions. Recently, research has been conducted on anti-citrullinated peptide antibodies (ACPAs) to which there are greater sensitivity and specificity than RF. However, these antibodies have also been described in infectious diseases, particularly tuberculosis (TB), placing the high specificity of the test in doubt. The aim of this research was to study the prevalence of ACPAs in TB, RA, and healthy controls. Patients with bacteriologically confirmed pulmonary tuberculosis, RA (ACR criteria), in addition to healthy controls were included. ACPAs were researched by: anti-cyclic citrullinated peptide (CCP), anti-modified citrullinated vimentin (MCV), and RF by ELISA. The study was conducted in 50 TB patients, 50 with RA, and 20 controls. Anti-CCP antibodies were found in 39 (78 %) of the RA patients (median titer, 128 U), whereas anti-MCV antibodies were found in 25 (50 %). Of the patients with TB, two (4 %) had positivity for anti-CCP and anti-MCV and no patient in the control group tested positive for these antibodies. Sensitivity of anti-CCP for RA was 78 % (confidence interval (CI), 63 to 88 %) and specificity was 97 % (CI, 89 to 99 %) while the sensitivity of anti-MCV was 50 % (CI, 35–64 %) and specificity was 97 % (CI, 89 to 99 %). RF was positive in 40 samples (80 %) of RA, in 30 (60 %) of TB, and in 1 (5 %) of the controls. Our findings showed high sensitivity of anti-CCP and high specificity of both anti-CCP and anti-MCV antibodies for RA, even in a population with high incidence of tuberculosis. The higher frequency of positivity of ACPA in TB observed in previous studies may be attributed to methodological factors.