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high anti ccp- doomed?? Expand / Collapse
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Posted Monday, January 26, 2009 2:41 PM


 

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I wonder could anyone help me understand the anti ccp figures. In August, despite having symptoms of severe joint pain the Rhuemy dx ed seronegative RA as my bloodwork including RF and anti CCP (think thats the terms) were normal

I was feeling quite positive that despite the dx, I could beat this, and that I must have a mild case...Have been taking Mtx and Prednisone 10mg day for about a month now. Am having bloodwork done every fortnight (Does everyone do this...getting bruised arms already...)

Anyway, went back to Rheumy and got massive shock that my anti CCP is now greater than 250, in fact so high that they dont even bother with a number. The Rheumy explained that this is the greatest indicator that my RA is both rapid onset and also people with high anti CCP have greater likelihood of severe RA, leading to deformity and disability....

All my positivity (or was it denial) has been blown away. I dont understand how it can go to normal to off the scale in a few months?

What is anti CCP anyway? Can it be high and then go low again? iIs it just related to RA or does it have other significance? Am I definitely likely to get a severe case now? I am in my late thirties with 3 young children...am so worried about the future...

Post #4181523
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Posted Monday, January 26, 2009 4:44 PM


 

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Welcome to the world of RA where everyone is different and things can get better or worse without any apparent reason.  CRP is a measure of inflammation, similar to SED rate (also called ESR I think) and is a non-specific indication of the extent of inflammation somewhere in your body from some cause that may or may not be related to RA.  It can vary widely in either direction and some doctors agree with yours about the significance, while others say it does not show anything about the severity or prognosis.  Probably both groups of doctors are right for certain specific indivuals. but wrong for other specific individuals.  I think RA was devised by the Mad Hatter from Alice in Wonderland.

I started out with bloodwork often as you are doing but now I get it every two to four months because it has been stable for a while. 

Your feeling good may be more due to Prednisone than to suppression of your RA.  Prednisone is a strong anti-inflammatory that does a lot for most symptoms of RA but does less to stop the permanent damage than most other RA medications.  Most of us do not feel our RA is controlled unless we can get off Prednisone, or to as low a level as we can achieve.

I think your stress about the future is more likely to have an adverse impact on your health than properly controlled RA.  Many people with any chronic illness need some kind of medication to relieve stress and anxiety.  Those are sometimes as effective as specific RA medications for helping a person.  I hope you get effective treatment.  God bless.

Edited to correct error where I give information about CRP but call it anti-CCP.  I got my hands started before engaging my brain.  Sorry about that.  I try to be helpful, but I can make mistakes.  God bless.

Age 82, diagnosed RA 12/2001, married since 1952, 4 sons no daughters, 4 grandsons 1 granddaughter.  Doing well on Methotrexate and Remicade.

Post #4181561
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Posted Monday, January 26, 2009 5:14 PM


 

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Hi,

I've never seen a specific number. Mine just comes back HIGH which is anything > 60. That is the top category at my lab.

It can go back to normal, but if you have chronic RA then it will likely stay high.

I have to disagree with Grandpavan. Anti-ccp is not a measure of inflammation. I think he was thinking crp which is another measure of inflammation. Anti-ccp is an antibody against a protein. If you have these antibodies its associated with RA/autoimmune diseases.

I also don't think it means anything about the severity of this disease for you. I think a high one means that you are likely to have chronic RA, but it gives no indication of whether or not the drugs will work for you. I have the high anti-ccp and got great control with Enbrel (as soon as it came out) and now great control with Rituxan. If these drugs had been available when I was dx'ed, I'm sure I would not have as much damage.

Being relatively new to this game, there is no reason to believe that you won't do extremely well. My rheumy told me to find Drs. for hands, etc. that are oldish (at least 50) because they just aren't see as much damage any more with the new drugs.

You are not doomed. But, you are likely to need quarterly visits to the rheumy and take drugs to control it. You can do this. You will most likely do very very well.

At first my bloodwork was negative too. That is very common.

I've had this for 20 years. My daughter was 1 when this started and she has grown up and is doing quite well as your children will too. They adjust. If you can't do everything that is ok. The children also learn about health issues and learn to respect people's differences and needs. It can actually be good for them.

Judy

Start 1989, DX RA 1994 On Rituxan, plaquenil, mobic, minocycline- In remission.

Post #4181575
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Posted Monday, January 26, 2009 6:16 PM


 

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I understand your feelings, when I saw my Dr he ran the ESR-SED which normal for my age is under 20, mine came back 137, I was like you a little shook up by such a high number.  But it promted my Dr to run multiple tests, arthritis panel, lupus panel even cancer screening tests.  Everything so far has came back normal, but six weeks after the first SED he ran another and it came back 139.  I am now being sent to a rheumatologist.  So while I am not happy about such an extremely high sed rate, I do think if everything came back normal including the sed rate, the Dr may have taken a "wait and see" approach.  I think maybe if a test shows a high reading we may be taken more seriously and treated more aggressively by some physicians.
Post #4181591
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Posted Monday, January 26, 2009 7:20 PM


 

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Holly, welcome. sounds like you have a fabulous doctor who is monitoring you closely. That is important. He is taking it seriously and will treat you aggressively. It can take a while for MTX to work completely and pred is partially a "false feel good" durg. Its steriods reduces inflammation but is only a mild DMARD. (disease modifying anti rheumatic disease). You'll need more medications and they should be strong DMARDS not mild ones. Its common to even be on triple therapy to prevent damage.

You are lucky you have it now. We have many more medication options AND recent research indicates hit it hard to start with. They use to gradually increase medications as they saw the damage, now they start to prevent damage.

I'm on triple therapy with a severe version and am (knock on wood) in remission. Doing great.

This disease can be very upsetting. Try to keep your head up, its not your fault. You are strong and you will manage quite well.

Anna
Post #4181605
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Posted Monday, January 26, 2009 7:24 PM


 

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There are CRP and CCP tests. CRP (C-Reactive Protein) measures inflammation. Anti-CCP is also called CCP. The formal name of the test is Cyclic Citrullinated Peptide Antibody.  The test can be ordered if the doctor suspects RA. It is more accurate than the RF test when the doctor suspects RA.  There's pretty good info at http://labtestsonline.org/understanding/analytes/ccp/glance.html.

You can ask for a copy of your lab results and then research what all those tests mean, if you are so inclined. The lab always mails me a copy and I have a growing notebook where I keep them, along with explanations of the various tests. I feel more in control if I know what's going on, but that's just me. Others are more comfortable not knowing. The thing with this disease is that you have to do what works for you.

As to being doomed. No. You are not doomed. Your life will be different than what you'd planned, but the future can be bright. Twenty years ago, this diagnosis would have meant a strong probablilty that you'd be in a wheelchair within a decade.  That is no longer the case. There are many different treatment options available, and it is possible to halt or severely limit disease progress.  My RD told me that he believes we can totally prevent joint damage; the treatments are that good now. That's me; it depends on what your x-rays showed initally. If one treatment doesn't work, you will try another, and keep trying until you find the right one that works for you.  That is why you faithfully see your rheumatologist.  Attitude plays a huge part in how well you do.  Stay positive, take you medicine, work with your doctor, and do low-impact exercises.  And on those days that you can't stay positive, forgive yourself and start over again.

If you still have questions after reading this board, write them down and take them to your next doctor's appointment. Definitely ask about your prognosis. Sorry so long-winded. HTH
+Rachel

 

+WarmSocks
______________________________________________________
Aiming for NED
  Plaquenil, Sulfasalazine, Methotrexate, Folic Acid, Feldene, Prilosec, Verapamil, Maxalt, Diclofenac Gel, vitamins

Post #4181606
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Posted Monday, January 26, 2009 9:13 PM


 

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Thank you all so much for your kind and knowledgeable replies. Thanks for clearing up the difference bet CRP and anti CCP, I understand better now

Warmsocks, I am like you and pour over every detail...its amazing how much you can suddenly find out about things one previously knew nothing about, and now Im analysing bloodwork results and the like...

Judy your words are encouraging that you managed with your daughter since she was one, and it is true, they do adapt. My three and four year old know that I cant do certain things with my hands. This leaves us stumped at times like when they need something fixed or the top off a jar or something. My four year old was suffering from scruffy hair as I tried my best to tie it into a neat braid in the mornings but it ended up looking awful and falling apart. But she decided to have her hair cut in a bob which is very chic and she now loves it....i felt terrible about it but she has assured me that braids are dumb and bobs are the way to go!

Thank you all once again, you inspire me with your knowledge and positive attitude

Post #4181626
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Posted Monday, January 26, 2009 9:31 PM


 

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Hi Holly,

RA and little ones is interesting isn't it?  Your little girl sounds like such a sweetie!!

All of my girls (except the baby) and I have long/longish hair -- I don't want to cut it!!  We have some braid days and some ponytail days. 

I'm glad that you found our board.  It has been so wonderful for me to have a support group without leaving the house!!  How great is that!?

I hope you post often!

Take care,

Shu-Shu

Post #4181633
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Posted Tuesday, January 27, 2009 11:03 AM


 

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I am like you and pour over every detail...its amazing how much you can suddenly find out about things one previously knew nothing about, and now Im analysing bloodwork results and the like...

In that case, I highly recommend a trip to the library or bookstore for two books

 

 

+WarmSocks
______________________________________________________
Aiming for NED
  Plaquenil, Sulfasalazine, Methotrexate, Folic Acid, Feldene, Prilosec, Verapamil, Maxalt, Diclofenac Gel, vitamins

Post #4181711
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