Rheumatoid Arthritis and RA factor

An autoimmune disease called Rheumatoid arthritis ( RA) damages the joints, resulting in persistent pain, inflammation, and stiffness. This chronic illness may also affect other organs in the body, resulting in different symptoms.

Our immune system normally produces antibodies to counter against pathogens that may cause illness. Rheumatoid factors(RA factor), on the other hand, are antibodies that may mistakenly target your body’s healthy tissues and cells, leading to an autoimmune disease.

What is the Rheumatoid factor(RF) test?

The rheumatoid factor test determines the amount of rheumatoid factor in your blood. The test identifies proteins known as rheumatoid factors, which are generated by the immune system and can counter-react to healthy body tissue. A positive rheumatoid factor test result means that your blood has a high concentration of rheumatoid factor. Rheumatoid arthritis and other autoimmune diseases are most frequently associated with elevated blood levels of rheumatoid factor.

A negative result of RA factor

If your rheumatoid factor test result is negative, it means that your blood does not contain much or any rheumatoid factor. It’s important to realize that a normal result does not mean that rheumatoid arthritis or any other health problem cannot exist. Rheumatoid factor levels in many rheumatoid arthritis patients may be low or non existent.

 

A positive result of RA factor

If your blood test shows a high level of rheumatoid factor, it does not necessarily mean that this factor is causing your symptoms. Rheumatoid factor can be present in both rheumatic and non-rheumatic diseases.

The accuracy of RF as a diagnostic tool depends on the specific patient being evaluated. This means that it may vary from one patient to another. It’s important to note that the timing of RF appearance in RA can vary among patients. In some cases, RF may appear before any symptoms, while in others, it may develop alongside the symptomatic disease. However, it is important to mention that not all individuals who test positive for RF will go on to develop RA.

 

Rheumatoid factor frequency in different diseases and conditions

Sl. No.	Diseases	Frequency, %
1.	Rheumatoid arthritis	70-90
2.	Juvenile idiopathic arthritis	5
3.	Psoriatic arthritis	<15
4.	Reactive arthritis	<5
	Other connective tissue diseases
5.	Primary Sjo¨gren’s syndrome	75–95
6.	Mixed connective tissue disease	50–60
7.	Systemic lupus erythematosus	15–35
8.	Systemic sclerosis	20–30
9.	Dermato-/polymyositis	20
10.	Dermato-/polymyositis	5–20
11.	Bacterial infections Subacute bacterial endocarditis	40
12.	Syphilis primary-tertiary	8–37
13.	Tuberculosis	15
14.	Coxsackie B virus infection	15
15.	Healthy 50-year olds	5
16.	Healthy 70-year olds	10-25

 

Clinical Significance

Patients with Rheumatoid Arthritis (RA) who have a positive rheumatoid factor (RF) test may have a more severe form of the disease affecting the joints. They may also experience additional symptoms like rheumatoid nodules and vasculitis. On the other hand, those with a negative RF test may have a less aggressive form of the disease. When you have elevated levels of rheumatoid factors in your blood, certain symptoms may point to an autoimmune disease or another medical problem. Rheumatoid factors are not present in the blood of everyone and some individuals with high levels may still be in good health.

As the above table shows (10-25% of healthy older individuals may exhibit a false positive RA result) Rheumatoid factor may be present in the blood of some healthy individuals even if they do not have any autoimmune diseases. Additionally, rheumatoid factor levels may be within the normal range in some people with autoimmune diseases.

Also it is observed that Rheumatoid factor is found to be very high in many patients after receiving a Covid vaccination, even though the patients do not have symptoms of rheumatoid arthritis.

So Just an RF test is not adequate for a diagnosis. Your doctor will review the results of other tests, your symptoms, and your medical history in order to make an accurate diagnosis. The sensitivity of RF testing for RA is reported to range from 60% to 90%, with a specificity of 85%. However, it is important to consider that exclusively monitoring RA disease activity based on RF levels is not currently recommended.

Doctors at Sree Subhramania Ayurveda Nursing Home, the best Ayurvedic hospital for Arthritis in Kerala, assess and admit patients based on a complete physical examination and a detailed case history, rather than just an investigative report. Then we develop a personalized treatment approach for each patient, including internal medication and panchakarma treatment.