Anti CCP Antibodies in Tuberculosis.

INTRODUCTION:Anti-cyclic citrullinated peptide (anti-CCP) antibodies have been considered very specific for rheumatoid arthritis (RA). Some studies have shown that these antibodies can be positive in infectious diseases like TB, HIV, etc. METHODS:Fifty patients of tuberculosis both pulmonary and extra-pulmonary were enrolled in the study from inpatient and outpatient departments from May 2012 to November 2013. Anti-CCP antibody test was done in all the patient by ELISA. RESULTS:Thirty one were pulmonary and 17 were extra-pulmonary and two were disseminated extra-pulmonary TB. Of the 31 cases of pulmonary tuberculosis, 12 cases (38.7%) were positive for anti-CCP antibodies and 19 cases (61.3%) were negative for same. Of the 19 cases of extra-pulmonary tuberculosis, two cases (10.52%) were positive for anti-CCP antibodies and 17 cases (89.48%) were negative. Of the 31 patients of pulmonary TB, nine were sputum positive and 22 were negative. Of those with sputum positive five (55.56%) were positive for anti-CCP antibodies and those with sputum negative 7 cases (31.81%) were positive for anti-CCP antibodies. CONCLUSIONS:Anti-CCP can be falsely positive in cases of tuberculosis. Positivity of anti-CCP antibodies for tuberculosis is more for pulmonary (more for sputum-positive than sputum-negative) than extra-pulmonary TB. Anti-CCP thus is not very specific for rheumatoid arthritis.