Aim: Autoantibodies against cyclic citrullinated peptide (anti-CCP) are considered to be a sensitive and specifi c marker for rheumatoid arthritis (RA). This study evaluated the diagnostic and analytical performances of the automated anti-CCP assay. Materials and Method: Sera from 80 patients with established RA, 65 from other rheumatic diseases (non-RA) and 55 from healthy controls were studied using second generation anti-CCP. Rheumatoid factor (RF) was also assayed in each sample, and the results were compared to the anti-CCP fi ndings. Serum pools were used to determine the precision and linearity. Results: At a cut-off of 7.4 U/ml for anti-CCP, the sensitivity and specifi city for RA were 65% and 98% respectively. RF had a sensitivity of 58% and a lower specifi city of 93 % than anti-CCP. Conclusion: The high specifi city of the assay suggests that anti-CCP is useful in the diagnosis of rheumatoid arthritis and in our cohort of study population anti-CCP exhibits a better diagnostic value than RF. A considerable proportion (28%) of RF-negative RA patients were anti-CCP positive. Based on analytical performance of the assay, we conclude that full automation and high throughput features of AxSYM makes it an ideal platform for routine testing of anti-CCP.

Ayurveda is a traditional medical system used widely in India and increasingly worldwide. Here, we report on a patient with Parkinson’s disease (PD) who developed marked striatal hand with antiparkinsonian medication withdrawal during Ayurvedic medicine treatment for her PD. Although a direct role for the Ayurvedic medicines in inducing the hand deformity cannot be excluded, we propose that severe dopaminergic defi ciency (due to prolonged withdrawal of antiparkinsonian medications in the context of long-standing PD) was probably the main culprit in our patient.