Understanding Rheumatoid Arthritis Lab Tests and Results; [updated 2018 Mar 26; cited 2020 Feb 12]; [about 4 screens]. The Anti-CCP Blood Test Normal Range is lower than 20 u/mL. When a patient is positive for Anti-CCP and RF, it is likely they have RA and may be more likely to have a more rapidly progressing and severe form of the disease. Anti-CCPs are antibodies also produced by the immune system. A more aggressive course of the disease may be experienced if you are positive for anti-CCP. In case studies, higher omega-3 fatty acid levels are associated with a lower risk of anti-CCP antibody production [18, 19]. Anti-CCP Abs are considered of special interest in the diagnosis of seronegative RA. Positive CCP antibodies and positive RF, it likely means that you have rheumatoid arthritis. Your email address will not be published. 2003 Sep;62(9):870-874. The anti CCP blood test is a rather new test that is becoming widely used, but the standardized RF test is generally ordered along with it or instead of it by many providers. The joint is usually stiff in the morning, but will begin to loosen up during the rest of the day. How to differentiate between UTI and Pregnancy Symptoms? In addition to laboratory criteria, a patient must also exhibit clear clinical symptoms that are consistent with rheumatoid arthritis. Normal levels for men range from 0-15 mm/hr to 0-20mm/hr and for women 0-20 mm/hr/ to 0-30mm/hr, depending on age higher for people over the age of 50). A newly developed ELISA system utilises genetically modified citrullinated vimentin (MCV), a naturally occurring isoform of vimentin to optimize the performance of the test. Dental treatment that removed P. gingivalis reduced the production of citrulline in 55 RA patients [3]. Comment * document.getElementById("comment").setAttribute( "id", "adb85409cab5d46f80094351d2084977" );document.getElementById("a6cbe26769").setAttribute( "id", "comment" ); Save my name, email, and website in this browser for the next time I comment. Abdul Wahab A, Mohammad M, Rahman MM, Mohamed Said MS. Anti-cyclic citrullinated peptide antibody is a good indicator for the diagnosis of rheumatoid arthritis. Diagnosing and managing RA involves clinical evaluation by a rheumatologist, as well as several different laboratory tests that require blood work. Lee AN, Beck CE, Hall HM. Anti-CCP antibodies are abundant in rheumatoid arthritis, and tests measuring anti-CCP have a specificity of about 96% [1]. Omega-3 fats help by reducing inflammation that can increase the citrullination of proteins leading to an immune system reaction and increased anti-CCP [20, 21]. Anti-CCP antibody may be associated with a higher incidence of ILD in SSc. Several studies have found that rheumatoid arthritis patients are more likely to have gum disease as well as more severe forms of the disease [4, 5, 6, 7, 8]. 14-3-3: a novel biomarker platform for rheumatoid arthritis. If your CCP antibody results were positive, it means these antibodies were found in your blood. By becoming informed about the normal values for tests, as well as their own numbers, patients with RA can better communicate with the health care team and gain a better understanding about some of the information that is used in developing and monitoring their treatment plans. Anti-cyclic citrullinated peptide (anti-CCP) is an antibody present in most rheumatoid arthritis patients. Omega-3 fats help by reducing inflammation that can increase the citrullination of proteins leading to an immune system reaction and increased anti-CCP [20, 21]. Our aim was to investigate the newest generation anti-cyclic citrullinated peptide (CCP) antibody 3.1 assay in diagnosing rheumatoid arthritis (RA) compared with other autoimmune and non-autoimmune diseases. Whether anti-CCP levels may change during treatment according to clinical response is matter of debate. This marker can indicate the level of inflammation in your body. He is the author of numerous health-related books and contributor to several medicine, health and wellbeing websites. This usually takes less than five minutes. Available from: Merck Manual Consumer Version [Internet]. With these laboratory tests as a guide, the healthcare provider may need to make adjustments to the patients medications and RA treatment. Rheumatoid Factor (RF); [updated 2020 Jan 13; cited 2020 Feb 12]; [about 2 screens]. A positive anti-CCP test result can be used as a prognostic tool to determine the severity of symptoms the patient may have throughout their disease course. Remember that this is just the beginning. The earlier someone can be diagnosed with anti-CCP positive rheumatoid arthritis the sooner targeted treatments can be initiated. A related blood test known as anti-cyclic citrullinated peptide (anti-CCP) test is also available. In addition to rheumatoid factor, another test which is ordered when rheumatoid arthritis is suspected is the anticyclic citrullinated peptide (anti-CCP). Despite the name, however, RF is not specific to RA, and there are many factors that can impact RF lab results. The anti-CCP Master curve material (Siemens Healthineers) with 5 preassigned levels of 0.4, 45, 90, 135, and 180 U/mL was tested in duplicate, and the linearity was evaluated by comparing against expected concentrations calculated from the linear fit and statistically best polynomial fit. When there are the signs and symptoms of arthritis present, then the anti CCP blood test may be ordered to eliminate or confirm the possibility of rheumatoid arthritis. The RF isotype will be established using the routine method and the results of anti-CCP and RF plasma levels are already known and this information is available in the patients files. Of course this test would also be coupled with an RF factor test. A positive anti-CCP usually means that you have rheumatoid arthritis. 16 of anti-CCP antibodies or X-ray damage at first presentation, and poorer long-term 17 function as measured by HAQ; and 18 elevated CRP, elevated ESR, presence of RF, presence of anti-CCP antibodies or X-19 ray damage at first presentation, and radiological progression. Although this test isnt specific enough to create a diagnosis on its own, about 95% of people who have a positive test result will be able to meet the diagnostic criteria for rheumatoid arthritis at some point in the future if they do not meet them immediately. is anyone else doing regimine like this? These proteins are components of complement, proteolytic activity, cell recognition, endocytosis, and response to biotic stimuli amongst others. Nor do we recommend anything we wouldn't use ourselves. Epub 2014 Oct 30. Autoimmune Disease: What Are They And Do I Have One? If the sample finds the presence of anti-CCP at a certain level, the result is positive. Anti-citrullinated protein antibodies ( ACPAs) are autoantibodies ( antibodies to an individual's own proteins) that are directed against peptides and proteins that are citrullinated. To help in diagnosing rheumatoid arthritis, the anti CCP blood test is done. They are present in the majority of patients with rheumatoid arthritis. Anti-CCPs are antibodies the immune system also produces. Reference range. A complete blood count (CBC) test looks at red and white blood cell counts. Available from: Rheumatoid Arthritis: Rheumatoid Arthritis Support Network [Internet]. The higher the levels of anti-CCP antibody, the more likely it is to suggest RA. They are almost never found in people who don't have the disease. Cyclic citrullinated peptide (CCP) antibody testing detects and measures CCP antibodies in the blood. The result is positive if the blood sample contains anti-CCP at a specified level. CCP Antibodies IgG/IgA. Although several studies have been published aiming to identify the prevalence of anti-CCP in patients with different rheumatic conditions2,3,4 . 12922961. It is possible to have an autoimmune disorder like rheumatoid arthritis and have a negative anti CCP blood test. Clinically, cyclic citrullinated peptides (CCP) are frequently used to detect these antibodies in patient serum or plasma (then referred to as anticitrullinated peptide antibodies). Interpret your laboratory results instantly with us. Masson-Bessiere C, Sebbag M, Girbal-Neuhauser E, et al. Autoantibodies; [updated 2019 Nov 13; cited 2020 Feb 12]; [about 3 screens]. CCP antibodies are produced by the immune system and can mistakenly attack healthy tissues. Some levels of ANA can be found even in healthy people. CCP testing was performed mainly to evaluate patients with joint pain. . Mean duration of follow-up was 2.7 years, and during follow-up, 73 patients (21.5% . The blood sample is then placed and analyzed in a lab. 6 Where are anti CCP antibodies found in the body? Since anti-MCV antibody levels at baseline predict disease activity at 2 years, anti-MCV antibodies might be superior as compared to anti-CCP an- To the Editor: We read with interest about the study by Payet, et al investigating prevalence and discriminatory value of anticyclic citrullinated peptide (anti-CCP) antibodies in patients with rheumatic diseases other than rheumatoid arthritis (RA)1. Sjogren syndrome, Graves disease, and lupus are all possibilities with a positive test result. Some providers may not have the appropriate testing facilities to determine results from the anti CCP blood test. In some cases, patients who display symptoms of rheumatoid arthritis but who test negative for anti-CCP could still have rheumatoid arthritis or develop it in the future. September 2020 review byTheodore R. Fields, MD, FACP. [18] Anti-CCP is also very useful in the early diagnosis of rheumatoid arthritis in high-risk groups, such as relatives of RA patients,[19] although Silman and co-workers found that the concordance rate of developing RA was 15.4% among identical (monozygotic) twins and was 3.6% among fraternal (dizygotic) twins. CCP. These attacks can produce inflammatory symptoms most commonly experienced in rheumatoid arthritis. Other conditions such as psoriatic arthritis, lupus, and hepatitis c can also cause elevations in anti ccp. Anti-CCP positive rheumatoid arthritis patients generally receive the most aggressive treatment options available including taking disease-modifying antirheumatic drugs (DMARDs) and supplementing withanti-inflammatory home remedies to provide symptom relief. Both tests are used to test disease activity; when they are high,this suggests that the disease is very active (assuming no other causes for high results, such as infection, are present). [12] Despite the excellent performance of these immunoassays, for example CCP-assays, they only provide a sensitivity comparable with that of rheumatoid factor (RF). The reference ranges for blood tests of anticitrullinated protein antibodies are: Anti-CCP is part of the 2010 ACR/EULAR classification criteria for Rheumatoid Arthritis. Some labs report this same result using a different measurement notation, that is, as less than 20 EU/ml.) Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the joints, but can affect other parts of the body. Available from: Arthritis Foundation [Internet]. Anti-CCP or ACPAs is a protein and is mostly found in the joints of patients who are suffering from rheumatoid arthritis. doi: 10.1016/j.jbspin.2014.06.001. CCP antibodies are found in more than 75 percent of people who have rheumatoid arthritis. 5 Reducing inflammation in the body could help reduce joint pain. Studies show that in anti-CCP positive patients, higher levels of omega-3s slowed the progression of inflammatory arthritis symptoms, but further study is needed [20, 22]. Hello: my CCP has climbed up in the past year from ~25 to ~77 to ~147. This includes a complete blood count, synovial fluid testing, and ANA blood tests. all my numbers look normal except my CCP Antibody IgG is > 500 (where they same normal range is < 16). Anti-CCP The daily pain, stiffness and swelling of rheumatoid arthritis can go undiagnosed for months causing permanent damage to your body. The cost to maintain this website grows each week. Dr. Charles Talakkottur answered Internal Medicine 63 years experience Yes but less likely: Anti ccp is fairly specific for ra. Most patients with rheumatoid arthritis have anti-cyclic citrullinated peptide (anti-CCP). You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication, or have a medical condition. But then there are doctors who just dont want to give a definitive diagnosis for whatever reason. Some individuals with a confirmed tuberculosis diagnosis have also been known to have a positive anti CCP blood test. (At Hospital for Special Surgery, anti-CCP is reported in Units. Laboratory tests provide important information in the diagnosis, management and treatment of rheumatoid arthritis. Also, the stimulating effects of caffeine help to fight physical and mental fatigue that is common with rheumatoid arthritis. Anti-CCP positive patients can potentially experience a more aggressive disease course. The pain will eventually result in joint deformity and bone erosion. Rheumatoid factor was positive in 39/67 (58%) with erosive disease, vs. 11/37 (30%) with non-erosive disease. Cleveland (OH): Cleveland Clinic; c2020. . This test looks for CCP (cyclic citrullinated peptide) antibodies in the blood. Test CCP: Cyclic Citrullinated Peptide Antibodies, IgG, Serum: Clinical and Interpretive; [cited 2020 Feb 12]; [about 2 screens]. Required fields are marked *. However we do not offer any products or services that haven't been thoroughly vetted by us. One study of 127 rheumatoid arthritis patients looked at the effect of taking sweet wormwood (Artemisia annua) or a placebo in addition to standard immunosuppressive drugs. Conclusion: The anti-CCP antibody assay has a similar diagnostic sensitivity to that of RF in early RA, but is better as a predictor of the disease course over 3 years. Other blood tests are also performed in conjunction with the anti-CCP test, including testing for rheumatoid factor (RF) antibodies and increased inflammation levels. Rheumatoid Arthritis; [updated 2018 Aug 28; cited 2020 Feb 12]; [about 3 screens]. If anything fails to meet your standards in any way please contact us so that we may consider removing it from our recommendations. Here, we describe a patient with RM with strongly positive anti-CCP, IgM RF, and chemokine (C-X-C motif) ligand 13 (CXCL13) levels in CSF that normalized after treatment suggesting a potential use of these markers in both diagnosis and treatment management of RM. That is to say: the following substances have been found to decrease both inflammation and, by proxy, anti-CCP levels. Note that each number in parentheses [1, 2, 3, etc.] Available from: Cleveland Clinic [Internet]. Laboratory studies showed normal blood count, an erythrocyte sedimentation rate of 45 mm/h, C-reactive protein of 3.39 mg/dL, rheumatoid factor of 393 IU/mL, anti-CCP level of 500 U/mL, antinuclear antibodies (ANA) 1/100 positive, anti-dsDNA positive with 43.2 positive, and C4 13.2 mg/dl. Although the mean serum level declines, anti-CCP antibody . Both the CBC and the complete metabolic panel are used to monitor disease activity as well as side effects and efficacy of medication. It's often done along with or after a rheumatoid factor (RF) test. 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 . Vitamin D deficiency is linked to both rheumatoid arthritis and higher anti-CCP antibodies. About 20% of RA patients are seronegative, meaning that their RF and anti-CCP lab results both continue to come back negative. Anti-cyclic citrullinated peptide (anti-CCP) antibodies are commonly found in patients with rheumatoid arthritis (RA), an autoimmune disorder that destroys the joints throughout the body [ 1 ]. Anti-CCP is an autoantibody. A blood sample is drawn from the patient and analyzed in a lab. RASN is dedicated to providing the most up to date and trusted information. This test could also determine the presence of anti-CCP, which can be found in almost half of the patients either before or during the diagnosis. Anti-MCV levels in the cases . Result Id. All of our content is written by scientists and people with a strong science background. A positive anti-CCP test typically indicates rheumatoid arthritis. Mayo Foundation for Medical Education and Research; c19952020. While a high CCP may mean a possibly aggressive disease course, it must be looked at with the amount of swelling, inflammation in the blood, and the number of joints involved. [3] These new classification criteria include ACPA testing, and overruled the "old" ACR criteria of 1987 and are adapted for early RA diagnosis. A patient with rheumatoid arthritis who has positive blood tests for anti-CCP has what is commonly referred to as seropositive rheumatoid arthritis. Some folks actually have high RF levels, high anti-CCP, high CRP, and high ESR level, and definitely do NOT have RA." Your rheumatologist may be taking a conservative . Anti-CCP is an autoantibody. Objective. Women are generally more likely than men to develop the signs and symptoms of rheumatoid arthritis, especially those between the ages of 45-60. [11] We are dedicated to providing the most scientifically valid, unbiased, and comprehensive information on any given topic. Rochester (NY): University of Rochester Medical Center; c2020. It is worth noting that not all patients with low levels of anti-CCP mean that the result is positive. Clin Lab Sci 2008;21:15-8. If CCP antibodies are found in your blood, it can be a sign of rheumatoid arthritis. Higher levels of antibodies to P. gingivalis are linked to higher levels of citrulline [3]. A positive anti-CCP usually means that you have rheumatoid arthritis. It is thought to be a combination of genetics and environmental factors. It is calculated by measuring the rate at which red blood cells sediment in a test tube in one hour. If the result is lower than 20 u/mL, you are positive for anti-CCP, but if the result is 20 u/mL or higher, you are negative for anti-CCP. Ann Rheum Dis. Objectives: Anti-cyclic citrullinated peptide antibodies (anti-CCP) are a serological marker of rheumatoid arthritis (RA), and also have a prognostic value for more aggressive disease. which enables users to obtain detailed information and reports based on their genome. Applies only to results expressed in units of measure originally reported by the performing laboratory. If the patients hemoglobin levels indicate anemia, this will be further investigated looking for its cause. Anti-CCP positive testing is also used to help doctors deliver a prognosis because many anti-CCP positive patients experience severe rheumatoid arthritis symptoms. Available from: Mayo Clinic Laboratories [Internet]. Orlando, FL 32801 More Information Juvenile idiopathic arthritis All rights reserved. If you are experiencing symptoms of rheumatoid arthritis, your doctor will most likely require you to undergo an anti CCP blood test. This test which is conducted on RA patients is a prognostic tool to determine the severity of the problem. Other names: Cyclic citrullinated peptide antibody, anticitrullinated peptide antibody, citrulline antibody, anti-cyclic citrullinated peptide, anti-CCP antibody, ACPA. A negative result means no CCP antibodies were found. [13][14] Unfortunately, these artificial antigens are not expressed in the affected tissue, and therefore are probably not directly involved in the pathogenesis of RA. Signs and symptoms may include: If these are felt, then the anti-CCP blood test may be required by your doctor. Inflammation is a type of immune system response. It is a blood test that can help you identify the presence of antibodies which causes rheumatoid arthritis. Los anticuerpos nos protegen de las enfermedades combatiendo sustancias extraas como los virus y las bacterias. Some labs report this sameresultusing a different measurement notation, that is, asless than 20EU/ml.) They are continually monitored by our internal peer-review process and if we see anyone making material science errors, we don't let them write for us again. Get more fiber in your diet with foods such as: fresh fruits and vegetables. If their shapes are significantly altered, the proteins may be seen as antigens by the immune system, thereby generating an immune response.[2]. CCP antibodies are produced by the immune system and can mistakenly attack healthy tissues. Its important to note that once the RF level is elevated, it will often remain so even if the disease goes into remission. The normal level of anti-CCP is less than 20 u/ml. Smoking increases the citrullination of proteins that can trigger an autoimmune reaction [14]. New York: Hospital for Special Surgery; c2019. Niewold TB, Harrison MJ, Paget SA. Natural Factors That May Decrease Inflammation in Joint Disease, Joe Cohen flipped the script on conventional and alternative medicine and it worked. Anti-CCP is a type of autoimmune antibodies against citrullinated proteins (CCP). [6][17] Noteworthy are the findings of a recently published study that highly valuates anti-MCV test systems for diagnosing rheumatoid arthritis in anti-CCP-negative patients. China's Foreign Ministry on Wednesday slammed the committee's three-hour hearing, calling it "cold war thinking" tainted by "ideological bias," and called for U.S. lawmakers to "stop . In some instances, patients with negative anti CCP test still manifest symptoms of rheumatoid arthritis. What is the normal range of Anti-CCP? SelfDecode does not treat, diagnose or cure any conditions, What does a positive Anti-CCP test result mean? Available from: National Heart, Lung, and Blood Institute [Internet]. Do you all know of other sites for people with my similar issues?? Inflammation; [updated 2017 Jul 10; cited 2020 Feb 12]; [about 3 screens]. If both . The prognosis of anti-CCP positive patients also depends greatly on early diagnosis of rheumatoid arthritis as well as early initiation oftreatment. Rheumatoid arthritis is first and foremost a clinical diagnosis. At 20u/mL and higher, an anti-CCP test is considered positive and, with other symptoms and factors, is usually a sign of rheumatoid arthritis. The normal level of anti-CCP is less than 20 Units. If the test results indicate the presence of RF without CCP antibodies, there are antibodies without RF, or both are present but in low levels, then this may be an indication of early RA. Citrulline antibodies are measured with a blood (serum) test that is analyzed in laboratories. The normal level of anti-CCP is less than 20 Units. It's a newer, much more accurate test. Atlanta: American College of Rheumatology; c2020. This test, however, can be influenced by factors such as obesity and infection and is not specific to RA. Los anticuerpos y los autoanticuerpos son protenas producidas por el sistema inmunitario. RF and anti-CCP are not used to monitor disease activity, because they both tend to remain positive despite remission. And an even better bill now exists at the federal level, thanks to Sen. Marco Rubio (R-FL): The ANTI-SOCIAL CCP Act, introduced in December, would ban TikTok . 2007. Some researchers have theorized that high anti-CCP antibody levels can be used to both identify and reduce inflammation in rheumatoid arthritis. What do high CCP IgG blood test results indicate? the objective was to perform detections by changing the anti-CCP levels and immobilizing the antigens. SelfDecode is a personalized health report service, These antibodies are detected in the laboratory using artificial cyclic citrulline peptides (anti-CCP Ab).This assay is far more sensitive and specific than rheumatoid factor . Some people with RA will have negative rheumatoid factor and negative anti-CCP. Based on his own health success, he went on to found SelfDecode, the worlds first direct-to-consumer DNA analyzer & precision health tool that utilizes AI-driven polygenic risk scoring to produce accurate insights and health recommendations. Rheumatoid Arthritis (RA); 2019 Feb [cited 2020 Feb 12]; [about 2 screens]. A level above 20 suggests the possibility of RA. The result is positive if the blood sample contains anti-CCP at a specified level. The earlier you address the symptoms of rheumatoid arthritis, the earlier you can find the appropriate treatment for the same. Remember to talk to your doctor before starting any new supplement or making significant changes to your diet. Production of anti-citrullinated protein antibodies (ACPAs) is an important biomarker for rheumatoid arthritis (RA). Testing for the presence of anti-CCP is a relatively new support tool in helping doctors diagnose rheumatoid arthritis. We undertook this study to determine whether genetic factors (HLADRB1 alleles) are associated with extreme ACPA levels in individuals with ACPA-positive RA, and to ascertain whether there are any phenotypic characteristics associated with these subgroups of RA. If your test result comes out positive, you must immediately consult your orthopedic doctor. SelfDecode has the strictest sourcing guidelines in the health industry and we almost exclusively link to medically peer-reviewed studies, usually on PubMed. Often, a patient with rheumatoid arthritis and positive anti-CCP test result is called having seropositive rheumatoid arthritis. Researchers have found that anti-CCP positive rheumatoid arthritis patients have a common sequence of amino acids called the shared epitope, which is encoded in specific genetic markers called human leukocyte antigens (HLA). Blood sample Order now PATIENTS HEALTHCARE PROVIDERS Anti-CCP If you have symptoms of rheumatoid arthritis, and your results show: Learn more about laboratory tests, reference ranges, and understanding results. Positive CCP antibodies and negative RF, it may mean you are in the early stages of rheumatoid arthritis or will develop it in the future. Doctor, author and fitness enthusiast, Ahmed Zayed, MD, is a surgery resident with a passion for helping people live a happy healthy life. There have however been reported significant falls in patients clinically responding to infliximab and to rituximab; anti-CCP has been . OBJECTIVE To examine the association of treatment response and disease duration with changes in rheumatoid factor (RF) and anti-cyclic . It is an inflammatory disorder that can also affect your body system, including your eyes, skin, heart, lungs, and blood vessels. If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please leave a comment or contact us at support@selfdecode.com. Our science team is put through the strictest vetting process in the health industry and we often reject applicants who have written articles for many of the largest health websites that are deemed trustworthy. [20], Given that ACPA are more specific than rheumatoid factor, they are used to distinguish various causes of arthritis. While additional pulmonary evaluation was being planned, a few . Since her cyclic citrullinated peptide antibody (anti-CCP) and rheumatoid factor tests were positive, rheumatoid arthritis (RA) was diagnosed and she was started on prednisone with plans for additional disease modifying therapy. The results will be analysed, the data proceeded and hopefully we will be able to answer the questions. Rheumatoid arthritis is a clinical diagnosis. This typically occurs when there are painful and warm wrist and hand joints. These antibodies are produced by the person's immune system and identify the body's tissue cells as foreign bodies and attack them. . Tilvawala R, Nguyen SH, Maurais AJ, Nemmara VV, Nagar M, Salinger AJ, Nagpal S, Weerapana E, Thompson PR. The Anti-CCP Test Procedure is just easy. Doctors will also use imaging scans to observe any signs of bone and cartilage deterioration around the affected joints. The average cost of Anti-CCP test in India can be anywhere between Rs 500 to Rs . Test Result Name. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. Learn more here. info@rheumatoidarthritis.org A positive result for cyclic citrullinated peptide (CCP) antibodies indicates a high likelihood of rheumatoid arthritis (RA). It typically is higher in the joints of people with Rheumatoid Arthritis ( RA) Given the high number it's possible this person has RA. The Fortune 500 should take note. Anti-CCP is thought to be present in 60% to 70% of patients with rheumatoid arthritis.