الفهرس 
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Abstract
Juvenile idiopathic arthritis (nA) is the most common rheumatic e of childhood. It is a clinically heterogeneous systemic une disease occurring in children younger than 16 years with an
characterized by arthritis persisting for at least 6 weeks without a cause (Schneider et al., 2002). JIA has three principal types of : oligo articular or pauciarticular disease, polyarticular, and systemiccdisease (Michael et al., 2008).
Anti-cyclic citrullinated peptide (Anti-CCP) antibodies are new tibodies directed to the citrullinated proteins, they can aid in the os is of adult RA and nA (Vossenaar et al., 2004).
The aim of this thesis was to detect the prevalence of Anti-CCP ’bodies and its relationship to clinical parameters and OI!set subtypes in ’dren with JIA and the reliability of Anti-CCP antibodies as a marker the diagnosis of JIA.
This study included 40 JIA patients aging 3.5 to 18 years who were bdivided to 3 subgroups according to JIA subtypes and 20 normal
ntrols aging 6 to 18 years. The patients and controls were subjected to medical history, clinical examination, laboratory and diological investigations. Serum Anti-CCP antibodies level were easured by ELISA.
There was a significant difference between patients and controls as regard platelets count, liver enzymes, ESR and positive CRP.
There was a significant younger age and lower weight in patients with systemic-onset JIA when compared to patients with polyarticular
, also there was a significant lower weight in patients with systemiccet JIA when compared to patients with oligoarticular JIA, the number ftender joints was significantly higher in patients with polyarticular JIA hen compared to both patients with systemic-onset and oligoarticular
There was a significant increase in serum level of Anti-CCP antibodies in oligoarticular JIA when compared to control. There was a lignificant increase in age and weight in polyarticular patients with positive Anti-CCP antibodies, and also there was a significant increase in disease duration and number of tender joints in polyarticular patients with positive Anti-CCP antibodies.
There was a significant positive correlation to age, disease duration, number of tender joints, number of swollen joints, and number of painful joints in JIA patients with positive Anti-CCP antibodies.
In conclusion, Anti-CCP antibodies can be considered a marker for diagnosis of JIA mainly. the polyarticular subtype and they are correlated with disease activity parameters which include the number of tender joints, raised ESR and positive CRP.