Which statement about laboratory markers in early inflammatory arthritis is correct?

• A Rheumatoid factor has higher specificity than anti-CCP antibodies for rheumatoid arthritis
• B Anti-CCP positivity indicates a uniformly better prognosis
• C A negative rheumatoid factor excludes rheumatoid arthritis
• D Anti-CCP antibodies can be detected years before clinical onset of rheumatoid arthritis ✓

Explanation

Anti-citrullinated peptide antibodies appear in serum years before the first clinical joint symptoms, making them valuable in early diagnosis. Anti-CCP has specificity around 95 percent for RA, higher than rheumatoid factor, so option A reverses the truth. Seronegative RA exists, so RF negativity does not exclude it. Anti-CCP positivity predicts erosive, more aggressive disease, which is a worse prognosis, killing option B.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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