RA-Factor:
Why RA-Factor Test?
CLINICAL INFORMATION
Rheumatoid arthritis (RA) is a chronic inflammatory - autoimmune disorder that predominantly affects the joints (causing painful swelling). Rheumatoid arthritis affects the lining of the joints causing painful swelling (becomes inflamed) that can lead to erosion of bone and joint deformity (deformities in the hands and fingers may cause a curved, claw-like appearance). These antibodies attack the synovial cells (cell lining in between the joints) resulting in inflammation (and due to inflammatory mediators like cytokines) thus causing damage to cartilage, tendons, ligaments and bones. Rheumatoid arthritis tends to cause damage to the small joints initially, especially fingers and the toes. As the disease progress it further spreads damaging the wrist, knee, ankle, elbow, shoulder, hip etc. moreover it tends to damage the bones' joints bilaterally (when one arm gets affected it affects the other arm too – the same joint in the other limb). It can further involve complications and hence is called “Rheumatoid Disease – RDi.e non-joint manifestation” (eg. Rheumatoid nodule, Rheumatoid lung disease etc), as it involves blood systems, skin, eyes, lungs, heart, blood vessels, kidneys, salivary gland, nerve tissue, bone marrow etc, and thus can result in physical disabilities. Symptom (clinical manifestations) that indicate rheumatoid arthritis is laboratory detection of Rheumatoid Factor (RF) or rheumatoid arthritis (RA) – factor, apart from clinical findings for rheumatoid arthritis including cardinal signs of inflammation – dolor (pain), calor (heat), rubor (redness), tumour (swelling) and loss of function. Further clinical manifestations (signs and symptoms) include abdominal pain, chest pain, fatigue, fever, stiffness in joints (gets worse in the morning i.e after sleep due to inactivity) causing joint pain, swelling in the joints etc. Rheumatoid factors are (abnormal antibodies) proteins (auto-antibodies that harm normal (healthy) cells, and further it can also bind to other normal antibodies produced by the immune system (auto-antibody that respond to inflammation caused by RA) and hence the tissue damage can cause long-lasting chronic pain. A positive rheumatoid arthritis (RA) test result for RF indicates the presence of high levels of rheumatoid factor detected in the blood. These circulating elevated levels of rheumatoid factor (RF) in the blood are closely associated with rheumatoid arthritis (autoimmune disease). Patients with Rheumatoid arthritis may also be affected by other auto-immune diseases. Rheumatoid factor (RF) test is indicated in patients who clinically manifest the signs and symptoms of Rheumatoid arthritis such as fatigue, joint pain, joint stiffness – usually in the morning (after sleep), swelling in the joints (tenderness), same bone joints on both sides of the limb getting affected (bilaterally), low-grade fever, loss of appetite, weakness, numbness and/or tingling sensation in hands etc. Types of Rheumatoid arthritis include Sero-Positive RA (patients with positive RF or anti-CCP blood test results), Sero-Negative RA (patients with negative RF and negative anti-CCP test result, but with RA symptoms), Juvenile Idiopathic Arthritis –JIA (the condition previously known as Juvenile Rheumatoid Arthritis -JRA) with symptoms of RA along with inflammation of the eye and growth (developmental) disorders. These signs and symptoms of Rheumatoid arthritis may get worse causing flares (exacerbations) and occasionally can be self-limiting resulting in remission (i.e symptoms disappear almost completely), up to some extent. The cause of Rheumatoid arthritis may be an infection caused by a certain virus or bacteria (but the exact aetiology of Rheumatoid arthritis still remains unknown). Risk factors (some aggravating factors can increase the risk of developing the disease) that contribute to added complications may include age, sex, genetics (inherited traits i.e certain genes called HLA class II genotypes), early life exposure, chronic stress, smoking, drinking excess alcohol, obesity with high body mass index (BMI), lack of movements (sedentary life) like lack of exercise, exercise with maximum high intensity etc. Untreated cases may lead to added complications (due to signal transduction by inflammatory cells resulting in the release of cytokines) such as osteoporosis, Rheumatoid Nodule - lump in the joint, synovial cysts, dry eyes and mouth, infections, carpal tunnel syndrome, lung disease, heart problems (premature heart diseases), lymphoma, interstitial lung disease, Rheumatoid lung disease, pulmonary fibrosis, cervical myelopathy, pneumonia, renal failure, GI haemorrhage, pancytopenia, subcutaneous nodules, sepsis etc. Other pathologies that might also elevate rheumatoid factor levels include chronic infections, hepatitis C, parasitic infections like malaria, HIV, herpes, syphilis, liver disease certain cancers, sarcoidosis (inflammatory lung disease), Sjogren’s syndrome, mixed connective tissue disease, SLE, leukaemia, multiple myeloma, infectious mononucleosis, tuberculosis, cirrhosis etc. Hence some of the added supporting tests that are needed to be performed to diagnose (confirm) rheumatoid arthritis are Anti-Nuclear Antibody (ANA), Anti-Cyclic CitrullinatedPeptide (Anti-CCP) antibodies, ESR, CRP, ELISA, ANCA etc. Other tests include D-dimer, synovial fluid analysis, imaging studies etc.
General Instructions:
Sample Requirement: Specimen - Blood sample collected from the vein. Test Preparation: None.
NOTE - Sample for specimen collections may vary based on the patient’s condition/cases according to the patient’s presenting complaints/signs or symptoms:
SPECIMEN REQUIREMENT (Special or Rare Cases) - As instructed and guided by Physician / Clinician / Pathologist / as per Laboratory’s requirements, according to procedures and protocols.
This Multi-Specialty Clinical Referral Laboratory RT DIAGNOSTICS provides precise and accurate tests with an extensive range of testing services to the medical centres to help in the diagnosis and identification of pathology in the test specimens for infectious diseases and also to evaluate the function of organ systems of the patient. It prevents further complications and helps to stabilize and restore health to near normalcy at the earliest without delay.
