Rheumatoid arthritis is an autoimmune disease that causes inflammation of the joints. It is diagnosed mainly by the description of the symptoms of the patient, a process we call history taking, and by examining the patient. With data that we get from history taking and from examination, we have most of the medical information we need for making the diagnosis of rheumatoid arthritis and for excluding the other medical conditions that could be mimics of rheumatoid arthritis.
When do we order antibody tests in patients with rheumatoid arthritis?
Having decided the diagnosis of rheumatoid arthritis, we order some lab tests for the patient. Some of the lab tests we order are to assess the extent of inflammation in the body. Other labs tests are to document the presence or absence of certain antibodies in the blood of the patient. Those tests are called the rheumatoid factor test (RF test) and the anti-CCP test. They are positive in some but not all patients with rheumatoid arthritis.
Value of the rheumatoid test result in patients with rheumatoid arthritis:
If the rheumatoid factor test was positive in a patient diagnosed with rheumatoid arthritis, then the patient has what we call seropositive rheumatoid arthritis. If the test was negative, then the patient has what we call seronegative rheumatoid arthritis. Some patients believe that seropositive rheumatoid arthritis and seronegative rheumatoid arthritis are two different diseases with different plans of treatment and different types of medications. This is not true. Seropositive rheumatoid arthritis and seronegative rheumatoid arthritis are one disease. Both of them are approached by rheumatologists in the same way. As a general rule, a seropositive rheumatoid arthritis disease is expected to be more intense than a seronegative one. This is a statistical fact but, at the end of the day, deciding on the types and strength of medications used in the treatment of a rheumatoid arthritis patient depends on the extent of the actual disease activity and severity that is documented by history and examination and investigations that reflect active inflammation and not on the mere expectation of a more intense disease based on an antibody test result.
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This post was prepared and published by Dr. Hatem Eleishi. Dr. Hatem Eleishi is a professor of rheumatology at Cairo university (Egypt) and is especially dedicated to supporting arthritis patients with online educational videos and articles about arthritis causes and treatment. He also runs a rheumatology clinic in Cairo and a center for online medical consultations that, in addition to providing online rheumatology consultations, also provides online medical consultations in several different medical specialties by expert consultants from Egypt, Canada and the United States.
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