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Rheumatoid factor (RF) is the autoantibody that was first found in rheumatoid arthritis. It is defined as an antibody against the Fc portion of IgG and different RFs can recognize different parts of the IgG-Fc. [ 1 ]
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.
Other rheumatological disorders that can cause the features typical for RS3PE include late onset (seronegative) rheumatoid arthritis, acute sarcoidosis, ankylosing spondylitis and other spondyloarthropathies such as psoriatic arthropathy, mixed connective tissue disease, chondrocalcinosis and arthropathy due to amyloidosis. [6] [9]
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.
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:
The diagnosis of RA was formerly based on detection of rheumatoid factor (RF). However, RF is also associated with other autoimmune diseases. The detection of anti-CCP is currently considered the most specific marker of RA. The diagnosis of rheumatoid lung disease is based on evaluation of pulmonary function, radiology, serology and lung biopsy.
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]
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