Doc, in my blood test they found the Cyclic Citrullinated Peptide Antibody (anti-CCP or ACPA) positive. Do I have Rheumatoid Arthritis?

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Sometimes, your doctor may ask for this blood test. Usually, the test is performed for people with pain/swelling joint. But on other occasions it can be done, for complaints that nothing has to do with arthritis in your joints.
We know that ACPA test has specificity for rheumatoid arthritis (RA) close to 97%. That means that people with arthritis and a positivity of this test, the probability of having RA is very high. But, what happens with people who have a positive test and they are asymptomatic?
They always ask, Doc, what are the chances to get RA? We have no answer to this question. We know that many patients with RA they have this positive test in his/her blood for many years before the disease developed. But also we know that many people with this antibody never will develop the disease. So, in case of being asymptomatic, the first question should be, why doctor you asked for this test? Did you have pain/swelling joint when the test was done? Any first-grade relative has RA? If you answer is yes to any of these questions, you need a close follow up by your rheumatologist. If this is not the case, you should ask your doctor, what was the point to inquire for this test that at this moment means nothing.

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