Can a positive CCP & RF be present in disorders other than RA?

Bones, joints and muscles
1

Is it possible to have a positive CCP in conditions other than RA? Obtaining info on this subject online hasnt been easy nor informative.

I'm really curious if these two tests can be positive/abnormal in other conditions.

I have previously tested positive for CCP and Rheumatoid Factor, I have numerous issues that all point to RA but my doctor has stated "he doesnt think I have RA but something is going on".. super helpful!

My results were:

CCP: 52 units

RF: 15 units

Currently undiagnosed and fighting for answers regarding my chronic pain.

Thank you very much for reading. I appreciate any information or input!

2

I've wondered the same thing myself. Hope someone has an opinion

3

 Rheumatoid factor is an antibody that is not usually present in the normal individual. Because rheumatoid factor antibody binds to normal antibodies, it can be generally referred to as an autoantibody. Patients who test positive for rheumatoid factor aren’t necessarily diagnosed with rheumatoid arthritis right away. There must also be a clear history of consistent rheumatoid arthritis symptoms, because Rheumatoid factor is also present in patients with other conditions, including other connective tissue diseases (such as systemic lupus erythematosus and Sjögren's syndrome), some infectious diseases (such as infectious hepatitis, syphilis, infectious mononucleosis, parasites, and tuberculosis), liver disease, and sarcoidosis. Rheumatoid factor can also sometimes be present in normal individuals without diseases. 

4

I know what you mean as Google isn't very helpful and everyone has such differing opinions, my numbers were 38 RF and 40 anti CCP and when I saw my consultant at addenbrookes which is a big research hospital who work with Cambridge university, he said based pretty much on my tests it is clear I have RA as to have both markers positive was almost a dead cert - RF on its own can mean nothing but having both when anti CCP is so specific meant that unless the results were wrong (I.e contaminated) then i had it, although it could be a very mild case at this point not requiring any treatment.

5

Norms for RA factor is anything at or below 15, so clearly this is a raised result for you.  CCP is normal if 30 and below for those over 50.  But then there are doctors who just don't want to give a definitive diagnosis for whatever reason.  I am hearing of that situation in areas that have gov't healthcare.

6

Hi,

But what about 'the window of opportunity' you read about? That makes it sound like as soon as you test positive for Anti CCP, you should start medication. My doctor pretty much showed me a list of drugs and said pick one. I too have very mild (majority of the time non-existent) symptoms, but tested positive for RF & Anti CCP. Inflammation markers are normal. I am 50. I received diagnosis in early 2014.

Regards,

Amy

7

Rheumatoid factor is found in about 80% of patients with RA - 20% of patients with an RA diagnosis are rheumatoid factor negative. 

Other diseases that can lead to increased RF levels include chronic infection, cirrhosis, or scarring of the liver, cryoglobulinemia (or abnormal proteins in the blood), dermatomyositis (an inflammatory muscle disease), inflammatory lung disease, mixed connective tissue disease, lupus and cancer. So do HIV/AIDS, hepatitis, influenza, viral and parasitic infections, chronic lung and liver diseases and leukaemia.

There are some apparently healthy people who have a positive rheumatoid factor - though a study suggests that they are at a 26-fold risk of developing RA at some later date. About 4% of young westerners have a positive rheumatoid factor. An RF of 15 is probably relatively low - above 20 IU/ml is considered high. It does depend on what "units" are used and every lab has its own normal range.

On the other hand - that CCP is high and does suggest there is "something going on" - so it needs investigating.

You say "your doctor" - is that a rheumatology specialist or a PCP/GP? 

8

Hi there, im in a similar boat, what are your symptoms....do you have swelling .....where do you feel pain. Did your doctor or rheaumy say what you might have? 

9

EileenH, Thank you for your input,..

I had a wide range of bloodwork done by my PCP after having chronic fatigue, pain and migraines for over a year (listed below on another response).. from the abnormal bloodwork results (CCP & RF) I was referred to a rheumatologist.

The RF was just above the normal mark for me.. I had (15 units) the lab stated:

"The "normal" range for rheumatoid factor is less than 14 IU/ml. Any result with values 14 IU/ml or above is considered abnormally high, elevated, or positive."

My CCP was 52 (positive) and the range on the lab was states as:

<20.0 U (negative)

20.0-39.9 U (weak positive)

40.0-59.9 U (positive)

> or =60.0 U (strong positive)

10

Hi Emily1234, I have minor swelling in my hands, feet and in my TMJ jaw joint.

I have a longg list of chronic complaints..

-Severe Daily Migraines – 5 or more days a week (since summer 2015) upon waking: dull all over pressure/tension headache, pain usually worsens as the day progresses. Pain is worse at the base of skull where neck meets & also forehead/temple/behind eyes.  Pain is pounding in nature which worsens with the headache; Exercise/movement/getting up worsens the pounding/throbbing factor.

-Joint & Muscle pain – tender, sore, achy, stiff:  Face/Jaw, Head/Neck, Shoulders/Back, wrists/hands, ankles/feet

-TMJD, jaw/facial pain, bruxism (in sleep), sleeping issues/unrefreshed sleep, frequent tinnitus

 -Constant Severe eye pain, pressure behind eyes, pain when moving eyes, extreme light sensitivity, blurry vision, seeing black/grey spots, Eye issues exist even when H/A does not

-Existing worsened Tremor - Hands

-Pins and Needles/Tingling in hands, occasional painful burning sensation in finger tips, ice cold hands and feet to the touch, Raynaud’s Syndrome

-Pain/Cramping/Weakness in hands after writing, weeding garden, molding clay, using scissors, issues can last for days after

-Constant Fatigue (even upon waking) that worsens as day progresses, lightheaded, occasionally dizzy upon standing or waking in morning

 -Memory loss/foggy minded, confusion/stumbling over words or struggling to find words

 -Visible Muscle twitches (feet/legs), tightness in calf muscle, occasional painful “charley horses” in calves & feet (mostly at night)

-Balance and Coordination issues – feeling unsteady on feet/tripping over own feet, feet “give out”, (falling in shower & down stairs) weakness in hands after repetitive motions, dropping items/items slipping out of hand, lack of grip strength/lack of strength to squeeze bottles (ex. Shampoo, child safe medicine caps), struggling with putting on jewelry (ex. necklace clasps & earrings) pre-existing tremor worsens all the above hand issues

11

i am so sorry to hear all of this....was the doctor not at all useful in giving some sort of insight. you have a lot of evidence there. Are you on any meds

12

Emily1234, out of curiousity do you also have abnormal CCP and RF but undiagnosed? The doctor didnt give me much insight but did give me meds to help cope in the meantime.. I'm currently in limbo between my neurologist and rheumotologist because my rheumotologist wanted me to follow up with my neuro and get an MRI to rule out many of the symptoms i am having because they are neurological symptoms. MRI came back normal except for apparently I have chronic sinusitis and inflammation (which i had no idea but think it relates to my chronic inflammed TMJ issue) but still gave no answers so im heading back to the rhuemotologist begining of November. Im on gabapentin at night to help my sleeping issues, restless legs and tmj pain issues. recently was put on prednisone taper (6 days to try and break a migraine cycle) by my neuro and it was the first time i went with out a migraine and debilitating pain for a few days. My migraines and pain came right back once the pred was stopped.

Chiropractic & physical therapy have done the most to help me.. but dont appear to be helping out long term.. I'm trying acupuncture tomorrow and looking forward to anything that helps my pain while i wait for the doctor merry-go-round.

13

Let me know how acupuncture works

14

i think you have to be patient and wait for that rheumy appointment - he's collecting evidence and ruling things out - all part of an overall picture that is important in deciding what particular autoimmune disorder you have as that sounds the most likely area. It is a very difficult field - even for experts.

15

Hi yes my CCP was only 23 literally toppled over the edge but negative for RF my mother has RA so don't know if it's in my genes! I just have sore joints and swollen knees but I do have tingling in my arms my rheamy said I am probable for RA but it could settle down due to low titre, did they do a full blood count for you? How are your CRP and ESR inflammation markers are they abnormal? They are key to inflammation in blood x

16

Low risk. You have a CRP level of less than 1.0 milligram per liter (mg/L).

Average risk. You have a CRP level between 1.0 and 3.0 mg/L.

High risk. You have a CRP level greater than 3.0 mg/L.

17

GOt sed rate norms mixed up with c reactive protein.  WHat I said above applies to sed rate.  C-reactive P is Low risk, if you have a CRP level of less than 1.0 milligram per liter (mg/L).

Average risk. You have a CRP level between 1.0 and 3.0 mg/L.

High risk. You have a CRP level greater than 3.0 mg/L.

18

Hi,

So are you saying higher CRP level means higher RA activity?

Thanks,

Amy

19

That is what my rheamy told me, apparently when you! find the right medication your CRP level should be less than 1 too. However i do know people that at diagnosis there CRPs were always normal but i do think most people especially with positive CCP or RF will show an elevated result

20

I have been diagnosed with RA last year but I have been going back and forth between Neuros and Rheumys for about five years on and off so I know how you feel, hearing the diagnosis of RA was almost a relief that I was believed that something was wrong. I now keep a spreadsheet with my monthly blood results so I can see how things are settling. Before my diagnosis My RF was 17 and my CCP >1(which here in Australia and the lab we use says it should be <7). Its very confusing the different way things are measured.

Although my Rheumy put me on MTX and Plaquinil and Pred I think She was still a bit undecided as I still had high levels of inflammation which was not coming down with the meds so she sent me for a bone scan to show where the inflammation was pooling and it showed huge amounts in ankles, feet and toes, wrists, hands and fingers so she immediately put me on a fortnightly biologic injection too which is giving me the most relief.

​I sometimes think that the blood tests dont show the whole story (as mine were not that high). I hope you get your result soon so that they can give you some relief.