Anti-Cyclic Citrullinated Peptide
Label Mnemonic: CCP
Epic Lab Code: LAB1254
Downtime Form: A-1a General Laboratory Requisition
Chemistry
6240 RCP
356-3527
Specimen(s):
Plasma
Collection Medium:
Plasma Separator Tube 4.5 mL
Alternate Collection Media:
Red top tube 5 mL (Clot Activator)
Minimum:
3 mL light green top (PST) tube or TWO Microtainer® devices
Delivery Instructions:
Deliver to laboratory within 2 hours of collection.
Testing Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around Time:
2 hours (upon receipt in laboratory)
Reference Range:
<3.0 U/mL
Comments:
Assay methodology and reference range changed November 11, 2014.

A positive result for cyclic citrullinated peptide (anti-CCP) antibodies indicates a high likelihood of rheumatoid arthritis (RA). Anti-CCP antibodies have also been reported in approximately 40% of seronegative RA patients, and, like rheumatoid factor (RF), a positive CCP antibody result indicates an increased likelihood of erosive disease in patients with RA.

Anti-CCP values determined on patient samples by different testing procedures cannot be directly compared with one another and could be the cause of erroneous medical interpretations.

References:
1. Banal F, Dougados M, Combescure C, Gossec L: Sensitivity and specificity of the American College of Rheumatology 1987 criteria for the diagnosis of rheumatoid arthritis according to disease duration: a systemic literature review and meta-analysis. Ann Rheum Dis 2009 July;68:1184-1191

2. Schellekens GA, Visser H, De Jong BA, et al: The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide. Arthritis Rheum 2000 Jan;43(1):155-163

3. Visser H, le Cessie S, Vos, K, et al: How to diagnose rheumatoid arthritis early: a prediction model for persistent (erosive) arthritis. Arthritis Rheum 2002 Feb;46(2):357-365
Test Limitations:
Immune complexes or other immunoglobulin aggregates present in patient samples may cause non-specific binding and false positive results. There is possibility of cross-reactivity in patients with anti- Centromere, anti-SS-A, and myeloma IgG.

Contaminated, icteric, lipemic, hemolyzed, or heat inactivated sera may cause erroneous results and should be avoided.
Methodology:
Multiplex Flow Immunoassay
CPT Code:
86200