This topic contains 3 replies, has 3 voices, and was last updated by 
lynnie_sydney 2 years, 4 months ago.
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I am posting this question on behalf of another forum member, its not about me.
The reason is because I am wondering if her symptoms are typical of RA or something else.
She emailed a photograph of her hand, and from what I could determine , it doesn’t have the text book pattern of inflammation usually seen in a two year course of RA.
Her RA factor is negative , SED and CRP consistently in normal range, but she has a low to mid positive Anti CCP.
No visible inflammation or pain on MCP or PIP joints, but obvious swelling on DIP joints, & experiencing pain in wrists & shoulders.
She has also spent a lot of time in the South of France , notorious Lyme hot spot.
Are there any other reasons apart from RA, that would result in a positive Anti CCP test , negative RA , SED & CRP ?
I have trawled through the internet, and have found a few articles that imply a positive Anti CCP test isn’t always 100% conclusive in confirming a diagnosis of RA.
Hi Lemons,
It sounds like me – aCCP positive, rest negative, and I have RA. (I have also made ANA [positive for me] test but you didn’t mention them).
Non medical test is 100% conclusive. In RA it is like SYMPTOMPS+TESTS+INTERPETATION = DIAGNOSIS.
No visible inflammation or pain on MCP or PIP joints, but obvious swelling on DIP joints, & experiencing pain in wrists & shoulders.
I had the same at the beginning – no one (except doctor) belived me that I am suffering any pain.
She has also spent a lot of time in the South of France , notorious Lyme hot spot.
She can make simple Lyme tests – they are not expensive.
Are there any other reasons apart from RA, that would result in a positive Anti CCP test , negative RA , SED & CRP ?
Yes, there are other reasons for positive aCCP (from Polish wiki – since it has better explanation than English wiki):
In major cases high ACCP means RA, other diseases that invlosves high ACCP are:
Juvenile idiopathic arthritis (2–40% sick persons)
Ankylosing spondylitis (1%)
Systemic lupus erythematosus (2–8%)
Sjögren’s syndrome (3%)
Scleroderma (5%)
joint inflamation in HCV virus (up to 5,7%)
Psoriatic arthritis (2–7,8%)
Lyme (2%)March 2016:
31 y.o. male, Poland, Europe.
Diagnosed with RA (started as palindromic rheumatism) at age 28 (SED negative, RF negative, CRP negative, Lyme negative, Chlamydia negative, ANA highly positive, aCCP/ACPA higly positive.
Treated with sulfasalazine - no success. Chloroquine - no success. NSAID - no success.
Treated with MTX injections (10mg->15mg->20mg->15mg->12,5mg->10mg->5mg) for 2years. Almost total remission. 3 months after MTX quit - got RA again with trippled strength.Maciej,
Thank you very much for the information.
lemons
This was very much my pattern when I first had symptoms – wrists were the first place affected. And the pain was excruciating. Came and went (usually every 4 weeks). There was no anti-CCP test here then but my RF was negative as were my ESR and CR-P. Between attacks, there was no visible swelling or indication anything was wrong. Eventually, my shoulders became involved and then attacks migrated around my body – but always to the larger joints. It was 2/3 years before my RF became borderline positive (eventually it became very high, but that was about 5 years down the track) but my SED and CRP always remained in normal range. Took me a long time to get any serious attention (these were the days when I was still consulting rheumatologists) but eventually I received a diagnosis of Palindromic Rheumatism.Many years later, I became aware of Lyme Disease and Lyme-like illness in which the classic beginning (of the rheumatological expression of this disease) is with Palindromic symptoms.
My story up to 2007 (before I became more aware of the likely Lyme) documents this. http://www.roadback.org/story/palindromic-ra/
Be well! Lynnie
Palindromic RA 30 yrs (Chronic Lyme?)
Mino 2003-2008 100mg MWF - can no longer tolerate any tetracyclines
abx from Sep 2018 MWF - a.m. Augmentin Duo 440mg + 150mg Biaxsig (roxithromycin). p.m. Cefaclor (375mg) + Klacid 125mg. Annual Clindy IV's
Diet: no gluten, dairy, sulphites, low salicylates
Supps: 600mg N-AC BID, 1000mg Vit C, CoQ10, P5P 40mg, zinc picolinate 60mg, B3 1000mcg, EPO 1000mg, Lithium orotate 20mg, Magnesium Oil equiv 400mg. Topical bio-identical estradiol, DHEA +
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