Antibodies directed to cyclic citrullinated peptides in familial Mediterranean fever

The aim of this study was to find the prevalence of anti-cyclic citrullinated peptide (anti-CCP) in patients with familial Mediterranean fever (FMF) and to examine the relationship between anti-CCP and joint findings. We measured the serum levels of the anti-CCP antibodies in patients with FMF (n = 55) and healthy controls (n = 43). Serum levels of rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen, ferritin, erythrocyte sedimentation rate (ESR), and white blood cell (WBC) were also measured in all the samples. Fibrinogen, ferritin, erythrocyte sedimentation rate (ESR), and RF levels were normal in the patient and the control groups (P > 0.05). There was a significant difference in anti-CCP between the patient and the control groups (P = 0.008). There was a positive correlation between arthritis and anti-CCP (P = 0.001). In patients without arthritis, there was no significant relationship between abdominal pain or fever and anti-CCP (P > 0.05). Anti-CCP levels increased in FMF patients with arthritis independent from acute phase reactants such as CRP, ESR, and fibrinogen. We conclude that in patients who are under investigation for arthritis, the ones with positive anti-CCP and negative RF, may be examined for FMF. In addition, we also conclude that it is very likely that FMF patients with anti-CCP antibodies will have signs of arthritis. On the other hand, it is possible that long-term follow-up of the FMF patients with anti-CCP antibodies may reveal the eventual development of inflammatory joint disease.