RA Factor

This is my second post I have quite a few health problems which I posted yesterday ,at the moment I am wating to see a Rheumatologist on the 14 March RA & Sjoren Syndrome, had some blood work done and they came back with a raised RA factor this has happened before and it was ignored, the reason being it was not raised enough , searching through some old medical notes I was given from my old Dr when we moved to West Wales , I found one blood test it showed that RA factor was significantly raised 34iu/L and that I had been informed which was untrue , if this was the case why did they send me to a Rheumatologist ? when I went to see her she again she took blood test when I went back to see her she diagnosed Fibromyalgia OA Cervical spondylosis & Acid reflux , at no time did she mention RA , however I found her letter which had been sent to my former GP which states quite clearly a weakly positive RA factor of 34iu/L , My question is how high does the RA factor be before they say yes its RA and as it gets worse does the factor go higher

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  • It's not quite as straightforward as that (like most things with inflammatory auto-immune diseases!)

    The rheumatoid factor is not a very precise test. Many people with a raised RF never go on to get active RA, and many people with active RA don't have a positive RF. So it's basically just a pointer towards the disease and isn't by itself a basis for diagnosis. It needs to be put together with other blood tests such as raised inflammatory markers and physical signs and symptoms to get a clear idea of what might be wrong.

    I know when I was referred to a rheumatologist for diagnosis the GP guidelines at that time were that there should be raised inflammatory markers and obvious signs of joint swelling that had lasted for more than 3 weeks. Whether of not the RF was raised was neither here nor there.

    34 is only just positive (20 is usually the tipping point). It can go into the hundreds, and there is a slight correlation with disease activity, but that's not absolute.

    Hope you get a good rheumy, who'll explain things better to you.

  • Hiya leechy27. It's Rheumatoid Factor you're referring to. As you know it's a blood test used to see if there's a suspicion you have anything autoimmune going on. But, approx 80% of 'normal' people have an RF so other blood tests need to be taken if it's elevated to determine if there's something inflammatory going on. The anti-CCP test for example is a more reliable rest, probably not taken by your GP but still, symptoms also need to be present to have a firm diagnosis. The swelling in the joints should be presenting typical signs such as inflamed, painful or boggy-type swelling so if a body exam didn't show those signs & any swelling was bony-type hard swelling maybe the GP suspected OA rather than RD, a Rheumy would confirm this. Similarly if the bloods the Rheumy took showed your RF wasn't raised enough, inflammatory levels ESR/CRP weren't raised & swelling was as explained that could explain the diagnoses you were given.

    I can't give you a comparison from when I was diagnosed because it was abroad & doesn't correlate but when I retuned to the UK in 2013 I had the normal screening to reinstate my meds (Rheumys don't rely on another's findings & have their own screening done!) & then my RF was 1280, confirming my seropositive diagnosis. My Rheumy also confirmed the OA first diagnosed with RD, including specifically cervical & lumbar spondylosis (OA in the neck & back)

    I'm afraid I think all you can do is sit out this next fortnight, try not to evaluate it too much & hope for a clearer indication of what's going on on the 14th. One thing my GP suggested was to stop the anti inflammatory & pain relief she prescribed a couple of days before my diagnostic appointment which was a fortnight later so if you're taking similar, even otc ones, it might be an idea if you do the same. The Rheumy needs to have a clear picture of you unmedicated, anything which could reduce your symptoms, inflammation or pain won't give a true image of you without them. He or she can then be sure of his or her diagnosis & have reliable baseline results for any treatment & doses he may prescribe.

    Of course if you have any questions in the meantime we'll help where we can. Let us know how you get on. Take care. 🙂

  • Hi nomoreheels

    Is that a play on words love that one I am now down to wear flat shoes even kitten heels I struggle with

    I have very swollen fingers and wrist, the middle joint of both fingers on both hands being the worst so very tender to touch and get stabbing pains in them but you get that kind if pain with Fibromyalgia, getting difficult to bend, and grip things, at times the joints look discoloured on the back, had this for while, I do have Raynaud in my hands the fingers go white while the backs stay red I am getting small lumps on my hands , and along the side of my feet have lumps under the skin on the inside of my wrist my knees have now started to ache as well as my ankles I have lost weight every cloud has a sliver lining bit flippant maybe

    I have had to stop yoga at the moment, as I cant put any pressure on my hands and wrist I can manage circuit training at the moment (over60)

    Don't take any medication apart form pip and Codeine anything else makes me dry heave and gives me headaches

    Have taken pictures of my hands at there worst

    so I will sit and wait with patience for the 14 March

  • You do seem to have quite a bit going on. Hopefully you'll have a clearer idea just what is when you see the Rheumy.

    My username is a bit of a misnomer nowadays. I did have to give up heels but since my feet have deteriorated my Podietrist wants me wearing either a wedge or block heel & it is working, along with personalised insoles I'm far comfier & walking a fair bit better.

    I'm not sure what you mean by pip but codeine is a painkiller & he/she needs to have you ooh & ahh in all the right places on the day so it might be an idea to stop it a few days before, so you're examined at your worst so to speak. Good idea to take pics of your hands, anywhere was too that flares up from now til your appointment. It'd be typical for all to be well on the day! Keep us updated.

  • Sorry that's was meant to ppi for acid reflux as soon as I had sent it I realized ooops to late

  • Oh of course, duh! 🙄

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