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There is an association between rheumatoid factor and more persistently active synovitis, more joint damage, greater eventual disability and arthritis. [12] [13] Other than in rheumatoid arthritis, rheumatoid factor may also be elevated in other conditions, including: Systemic lupus erythematosus (SLE) [14] [15] Sjögren syndrome [14] [15]
Rheumatoid arthritis patients often have high erythrocyte sedimentation rate (ESR, also known as sed rate) or C-reactive protein (CRP) levels, which indicates the presence of an inflammatory process in the body. Anti-cyclic citrullinated peptide (anti-CCP) antibodies and rheumatoid factor (RF) are two more common blood tests.
Lyme disease causes erosive arthritis and may closely resemble RA – it may be distinguished by blood test in endemic areas; Reactive arthritis – asymmetrically involves heel, sacroiliac joints and large joints of the leg. It is usually associated with urethritis, conjunctivitis, iritis, painless buccal ulcers, and keratoderma blennorrhagica.
Systemic autoantibody tests are used to: Help diagnose systemic autoimmune disorders. Help determine the degree of organ or system involvement and damage (Along with other tests such as a complete blood count or comprehensive metabolic panel) Monitor the course of the disorder and the effectiveness of treatments.
Given that ACPA are more specific than rheumatoid factor, they are used to distinguish various causes of arthritis. [21] Novel assays may be useful for monitoring disease activity and effects of RA therapy. [22] The reference ranges for blood tests of anti–citrullinated protein antibodies are:
Patients with drug-induced lupus erythematosus typically have positive tests for anti-histone antibodies but do not have indications for anti-dsDNA antibodies. Patients with idiopathic systemic lupus erythematosus have both types of autoantibodies present in their blood. Thus, this test can be useful in distinguishing these two illnesses. [9]
Their significance is greater than that of rheumatoid factor. Recently a serological point-of-care test (POCT) for the early detection of RA has been developed. This assay combines the detection of rheumatoid factor and anti-MCV for diagnosis of rheumatoid arthritis and shows a sensitivity of 72% and specificity of 99.7%. [4] [5]
Palindromic rheumatism is a disease of unknown cause. It has been suggested that it is an abortive form of rheumatoid arthritis (RA), since anti-cyclic citrullinated peptide antibodies (anti-CCP) and antikeratin antibodies (AKA) are present in a high proportion of patients, as is the case in rheumatoid arthritis. [6]
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