Do you have the Rheumatiod Factor or are you Sero Neg... - NRAS

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Do you have the Rheumatiod Factor or are you Sero Negative?

I am sero negative and one off my Rheumys said I had Sero Negative Rheumatiod Arthritis but other doctors have said it is not classed as rheumatiod it is Sero Negative Inflamitory Arthritis.

What is your diagnosis?

17 Replies

Hi Julie

The correct diagnosis of this disease is Rheumatoid Arthritis. It can be either sero-positive or sero-negative depending on whether certain factors show up in the blood. Inflammatory Arthritis is a general term used for a number of arthritic conditions that have inflammation and pain as the central symptoms. Many types of Inflammatory Arthritis are immune system disorders but some are not.

Before diagnosis my GP referred me to the rheumatologist with symptoms of Inflammatory Poly Arthritis. The rheumatologist's diagnosis was sero - negative RA, 23 years ago.

Lyn x

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That's a good question, I've been diagnosed 16yrs and all I've been told is that I have Rheumatoid Arthritis! I know the bit about what Lyn said about certain factors showing up in the blood that's about all I know.

But I will find out

mand xx


I have sero negative RA . The only difference is it does'nt show in the blood tests . Thats what they told me.


I was told I have an elevated RA level in my bloodwork. Does that mean I am sero-positive?


Hi, Lorrayne's daughter Gemma here (biomedical scientist). Rheumatoid factor is a pants test!!! It doesn't indicate RA, you can still have a positive rheumatoid factor (RF) and not have any symptoms relating to RA at all and could have a viral infection that is treatable. It is the first test requested when RA is suspected, but take it from a lab geek - it's a shit diagnostic test!! However there are patients with a positive RF, having RA, of course. This is where the test anti CCP (anti cyclic citrullinated peptide) antibodies is used by rheumatology consultants (it is my Trust's lab policy not to offer this test to GPs, only to rheumatology consultants) because although there is no specific test to diagnose RA, the anti CCP antibodies, in conjuction with RA symptoms and other tests (such as ESR and CRP- markers of inflammation), enables a rheumatologist to come to the conclusion the patient may have RA. So, for those of you with sero-negative RA, you've got a negative rheumatoid factor but are very likely to have anti CCP antibodies.

Mum was diagnosed sero-negative rheumatoid arthritis 20 yrs ago.

Jen- if by elevated RA level you mean rheumatoid factor, then yes you are sero-positive RA.

Disclosure--- please refer to more info from your consultants, I am not a consultant and can therefore not give diagnosis!!!

Ok, Lorrayne back, I asked Gem to stop or we could all end up with an essay that none of us understands fully as she could go into a lot more depth.Uh oh!! Basically LynW is quite correct in what she says, in fact I declare "Lyn you are our online RA blog boffin!"


Loved Gem's honesty :-)

I actually have no idea if I'm positive or negative, only that I've got RA & it hurts.

Will try and find out at my next appointment.


Ah well, that comes with travelling with RA for so damn long ... it just won't get off my back! Still, I don't allow it to travel first class and any signs of impingement and it gets shunted back to freight :) At the moment it's being rather persistent!

Thank you very much for the additional insight Gemma, much appreciated. I love info! One of my son's is about to embark on Biomedical Science at Lincoln Uni; I can't wait for 'us' to get started!! Digging my nose into all his work ... he'll have a fit but I'll have a field day :)

The RF test is useful in some circumstances as it can be accessed by GPs and can be used as a basic indicator of inflammatory health. It is not, however, these days used as a diagnostic tool for the purposes of RA. As far as I am aware anti CCP testing always requires the signature of a rheumatologist - GPs would have neither the training or expertise to understand the results. This test can assess the likelihood of onset of RA before symptoms even appear so very useful in that respect.

Sero-negative patients can be very difficult to treat simply because of the failure of the blood to accurately reflect what is going on. For example my ESR (not the most reliable of tests anyway) bubbles around at 16 or 17 and that is okay. It went up to well over 100 for 6 months and, after extensive testing, absolutely no evidence of inflammation could be found anywhere. I felt completely well. Now its 35 and I feel like it should be at least 135!

Thanks again Gemma. I (and Jake) would be interested to hear about your career progression if Lorrayne fancies 'messaging' me. You are the first Biomed Scientist we have come across!

Lyn x

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I always wondered what the difference was between sero negative and sero positive. I feel that it is imperative that a firm diagnosis can be made. Having a wishy washy diagnosis, which can be interpreted either way in a court of law, as in my case, caused my complete financial ruin. It also has an impact when applying for jobs, medical insurance (have you or have you not got RA), emigrating to the USA (if you really wanted to), getting disability benefits, if there are any other aspects that I have not recorded here, please make suggestions. I have not had a firm, unequivical, certified diagnosis which I can hand to whomever needs to see it. I have had an RA specialist for the past year and a half in Reading (Dr.Bradlow, from South Africa) who has put me through 4 MRI scans with no obvious signs of RA activity. He says he cannot give me a firm diagnosis due to this fact. All I know is that if I stop taking my medication for 2 days, I seize up and become exhausted. As soon as I start taking it again, and/or steroids, I recover. Is that in itself not an inconclusive sign that I have RA ?


Sorry, I meant a CONCLUSIVE sign of RA !


I'm sero-negative for rheumatoid factor - or at least I was. I was tested when I was diagnosed, but haven't been since - and it is possible to become sero-positive over time. But being sero-positive doesn't really mean anything, not least because you can be S-P, but not have any symptoms of RA!

There is no single reliable test/diagnostic criteria for RA - diagnosis arises from a weight of evidence that points to RA.

RA may yet turn out to be a collection of similar diseases characterised by a certain pattern of inflammation and blood markers - what is certain is that RA is far from being fully understood (but then what disease is?) What we have to hope for is improved treatment (and availability of treatment!) and better relief of our symptoms when treatment is not completely successful, i.e. most of the time for me. And perhaps for the younger amongst us, gene therapy or some-such might provide a cure, but not for a while....

We have at least a dozen rheumatologists working at the Haywood hospital (where I go). I have seen most of them, and have have heard lots of apparently conflicting information over the years - rheumatology is far from being a precise science and human bodies are each unique. Most rheumatologists are very knowledgable and do their best, but it doesn't mean they are always right!

Oooo, sorry, that turned into a bit of a rant - still, better out than in :)

Take care all

Tone x


I have absolutely no idea - would it help me if I did?


I was told that ESR should be around 35 for the rheumy to be happy, however if I am Sero negative does the ESR actually tell them anything?

My ESR seems to stay around the 70 mark. and I am not in remission.

I do wonder if remission actually exists or it's just an RA fantasy. x


Thanks for the info Gemma xxx

Thanks for everyones replies.

Ive been advised by my doctor and rheumy nurse that I need to learn as much as possible about my RA to be able to make sure I get the best treatment for it xx


Please be gentle, really looking for help!!!!!!

I was diagnosed three years ago with RA/OA and Gout,

Only tratment availible to me was Tramadol and Fentanly patch's to reduce the pain I was experiencing, this being that I am a renal transplant patient was unable to recieve normal.

I have had all the blood test, Xray hands, feet etc and steroid injections into ankle and knee's (didn't really help).

\recently I seen a different rhummie at clinic, he examined me and loads of questions ??? then to my amazement he stated that I didn't have RA but have chronic Gout!!!!

Apparently my blood tests show no raised RF/CPR levels but my uric acid levels ahve been off the charts for the last two years,

I know what gout is like I have suffered 2-3 attacks every year since having renal failure, althrough I take medication to control uric level,

However the pain I get on daily basis is not to dis-similar but does not go away.

c\an anyone offer any help/info of where I go from hear! rhummie increaseing my Alliprunilol, stay with pain med's and will see me in 9mths time.

Sorry about spelling of medication, but all downstairs and not to good on my feet today. Looking forward to any information anyone can offer.


I am sero negative and have been told that this just means that evidence suggests you may respond better to treatment... I have been on triple therapy for 5 years. The blood test doesn't really mean anything, you still have RA.


I know that now teddy I think I just had an awkward doctor at the time who was telling me that sero negative people didnt have RA it was inflammatory arthritis and not clased as RA, however I think that must have just been his opinion as all my records say RA and my current doctor calls it RA it was just the one temp doctor who decided to confuse me :)

Hope your triple therapy is working well :)


In the blood test,it diagnose that my rheumatoid factor is 41u/ml.Iam waiting for the rheumatologist appointment.can you please give me suggestion in this matter.


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