Sero Negative RA and Sero Negative Inflammatory Arthritis is it the same??

[Jennylaty]

Sero Negative RA and Sero Negative Inflammatory Arthritis

Can anybody explain to me the difference please.

[Pat9442]

As far as I am aware they are the same thing

[Jennylaty in reply to Pat9442]

Thankyou Pat.

[helixhelix]

The labels refer just to whether or not you have developed specific antibodies. Either way you still have an inflammatory arthritis.....

The is a lot of literature that says that sero-positive is more aggressive, and more difficult to treat, but stories on here don’t bear that out!

Personally I do think that in the years to come the scientists will discover that there are some subtle differences. But for us, now, both give the same pain and require similar treatment.

[Jennylaty in reply to helixhelix]

Thanks helixhelix for your reply, some research needed on my part

[RosieA]

I had the same question when I was diagnosed at the end of last year. I say diagnosed but in that intervening time things have changed. I was borderline ANA as was one of my immuglobulins (I believe these are things like RF). I am now ANA+ve and they are rechecking my immuglobulines. I thought I JUST had an inflammatory arthritis but now appears I may have two things developing. From what I have read at the beginning of this automimmune journey it's like being infront of a pick and mix. Some will only pick chocolate, e.g, RA, others may develop a taste for lemon drops and add it to the mix etc, etc. I'm obviously one of those who takes forever to make a decision. Only plus side is that I know considerably more about automimmune diseases than I did a year ago and my empathy levels are now at DEFON 1. As others have said the treatment is all very similar at this point. Hope that helps a little.

[Jennylaty in reply to RosieA]

Thanks for your reply. I need to do some homework.

[Marionfromhappydays]

This is quite spooky as I have just had a video consultation with my rheumatologist and I asked her exactly what I've been diagnosed with and she said sero negative inflammatory arthritis and I thought is that RA?

Silly I should have asked my Dr that!

Oh well, ive now just got to get my head around things (i am in the throws of feeling sorry for myself which I don't think helps).

[helixhelix in reply to Marionfromhappydays]

At the beginning sero-negative inflammatory arthritis can be “undifferentiated”, so it can turn into RA or psoriatic arthritis or ankylosing spondylitis. Sometimes docs like to sit on the fence for a year or two, to see what symptoms develop. Treatment is the same so not massively important, except it’s good to have a name!

[Marionfromhappydays in reply to helixhelix]

Thank you x

[Hidden in reply to Marionfromhappydays]

Marion feeling sorry for yourself is understandable and part of the process. Hang in there. ❤️

[Fruitandnutcase in reply to helixhelix]

That’s interesting, I‘ve got sero -negative inflammatory arthritis and I felt they seemed very keen to know if I had any rashes I wondered if they were thinking about psoriatic arthritis.

My CRP is always very low these days and I often wonder if that is because when I was diagnosed with inflammatory arthritis I decided I had finally had enough of autoimmune conditions and went totally gluten free.

[helixhelix in reply to Fruitandnutcase]

I eat gluten in the form of home made sourdough bread and pasta and also have low markers. My gut (🤭) feeling is that eating junk food doesn’t help, but any decent diet will. Each to their own, and trial and error.

[Fruitandnutcase in reply to helixhelix]

Should add that junk food although I didn’t ever have all that much, I cook mostly from scratch but it pretty much went out the window at the same time as GF came in.

[medway-lady]

I have pANCA antibodies and Positive RA my understanding is that its easier to treat positive as clear cut but some people are positive but never go on to develop the disease. It also means if positive you may well have other autoimmune conditions like me Thyroid, or others Diabetes, Lupus, Crohns etc . IBD, and it responds better to medications. Although often more aggressive it can affect younger people more.

[Hidden]

I’ve found they can sometimes be used interchangeably, but the difference between seronegative RA and seronegative inflammatory arthritis is that one is a definite diagnosis of a specific type of arthritis, the other basically means definitely arthritis, but we don’t know what type. They can sometimes make a seronegative RA diagnosis based on the fact that the different types present slightly differently. For example, RA is considered a bilateral disease, usually effecting both joints in a pair even if the initial presentation is only in one. PsA - which is routinely seronegative, and can occur even without a history of skin psoriasis - quite routinely only effects one joint in a pair, and only ever effects that one joint in a pair, never developing in the other joint even if left untreated. My current diagnosis is ‘inflammatory arthritis, likely psoriatic’ because scans prove I definitely have inflammatory arthritis, some of the effected joints are asymmetrical, I’m completely seronegative with perfect crp and esr even at the height of a flare, and I also have a brief, prior history of psoriasis from more than twenty years ago. They can’t say with absolute certainty, though, and in the absence of the psoriasis history I would be classed as a case of seronegative inflammatory arthritis because I only have one dodgy hip and one dodgy elbow, where for seronegative RA, it would either need to be in both, or develop in the second over time.

[RAexperiences in reply to Hidden]

Thank you Charlie that was very helpful (I’m not the writer of the original question). Could I ask you what meds you are being treat with and if they work?

Thank you

[Hidden in reply to RAexperiences]

You’re welcome 😊

I’ve had it for about 20 years but I’m actually a new diagnosis because for the last 10+ years everyone kept saying it couldn’t be arthritis because of my bloods. Even saw a rheumatologist who said he didn’t have a clue what could be wrong 🤦‍♂️😂 I finally got diagnosed in Jan after an incredibly painful bout of sausage fingers, and started on Methotrexate. I was already on steroids due to the flare that saw me referred to rheum, but found no improvement at all with just the mtx despite going up to 20mg. They added in 10mg leflunomide after about 4 months or so, and that seemed to help quite a bit to the point I finally got off the pred, but 7 months and 2 reviews down the line we’re not controlling it yet. Because I seem to be getting a lot of unpleasant skin side effects with the lef, they’ve left me on it at my request but put me up to 25mg mtx. My first pens arrive on Monday, although I’ve been taking the dose increase orally for the last 3 weeks. That said, I’ve got to go and have a ct this evening to check it (or the arthritis) isn’t giving me lung issues: if that comes back wonky, the mtx will probably have to go.

So what you have there is a very, long winded way of saying I’m on mtx and Leflunomide 👀😂 They’re definitely doing something in combination compared to how I was at Christmas, but I suspect my next review in a couple of months will be discussing trying something else entirely. From what I understand, PsA patients quite often end up on bios/JAKS etc. due to a lack of response to traditional DMARDs, but as with all arthritis, they take the stepwise approach to treatment in case orals actually do the job.

[RAexperiences in reply to Hidden]

Very much appreciate your response. Thank u Charlie.

[Hidden in reply to Hidden]

I was diagnosed 4 years ago and like you Charlie G suffered with many of RA symptoms for at least 15years but my bloods were good so I was repeatedly told I was suffering from depression. I kept saying I wasn’t depressed the only thing I was offered was antidepressants it was a relief to be diagnosed in the end.

[GranAmie in reply to Hidden]

v informative ! See my post above re MTX. Still wonder re my RA diagnosis tho' as I too am asymmetric and developed mild psoriasis 55 years ago.

[Hidden in reply to GranAmie]

RA is considered a symmetrical form, so my understanding is that to have that diagnosis with persistently asymmetrical joint issues would be a bit strange. Sometimes they wait to see if the second joint starts to show disease activity, as they don’t always manifest at exactly the same time, but with RA, it should happen at some point. Are you completely seronegative?

Just throwing this out there, but it is also possible to have more than one type of inflammatory arthritis at the same time. Rare, but entirely possible.

[GranAmie in reply to Hidden]

No - I tested +ve for the Rf factor inApril 2015, although developed PMR in ?'99 which stayed with me until abt 2010... started on 40mg pred and gradually reduced it to 5mg over that period. The neurologist said his best guess was PMR, tho' even muscle biopsies didn't confirm anything, so who knows. Main point is that Truxima [RTX biosimilar] seems to do the job.

[Hidden in reply to GranAmie]

Then you could potentially have both RA and PsA. Maybe even a triple whammy if the PMR was also accurate?! I suppose that’s the ‘nice’ thing about these conditions, though, that the treatment is pretty much identical, so the specific overarching diagnosis doesn’t actually make a huge amount of difference. It’s primarily just a question of finding which med(s) work for you.

[GranAmie in reply to Hidden]

yup.. makes sense, thanks... osteo arthritic thumbs and wrists have appeared in the last year or so... but hell, i'm 78 in Decembrr so haven't done badly. Delighted to hear swimming pools re-opening soon :-). I know sea swimming is better 4u but near drowning dec 2014 is what kicked off the main event and sea round N Ireland too cold for me... being a Dorset diva LOL Take care

[Jennylaty in reply to Hidden]

Thankyou Charlie very interesting reading.

[Mmrr]

I am sero negative, meaning I have no blood markers at all that I have RA.

But I do have all the other signs and symptoms of RA.

Older literature suggests that sero positive RA is more damaging, but more recently there has been a growing body of evidence that is not the case.

Seronegative RA can be more difficult to diagnose, due to no bloods to base a diagnosis on, delays in referral and treatment are therefore very common, making seronegative RA more advanced before appropriate treatment is established.

[Hidden in reply to Mmrr]

I too am sero- negative took years for diagnosis as my bloods were good. Like Mmrr Diagnosed by symptoms not bloods

[Fruitandnutcase in reply to Hidden]

Same here - diagnosis by symptoms not blood. I think it’s difficult being sero-negative, I’ve been told I’m in remission but I’d say my body tells me otherwise.

[Hidden in reply to Mmrr]

I had normal Rheumatoid factor but obvious RA but back then in the 1980s no one understood that you can have RA/IA without a raised RF. I was left for years then eventually my RF and CRP were sky high. 😔

[Mmrr in reply to Hidden]

😥

[BoneyC]

I've had RA for 50 years, dx as a child when they called it Still's Disease. As an adult it was always referred to as RA but I never knew about being + or - as no internet those days. About 10 years ago a new rheumatologist told me he thinks my RA was + but is now - .

Either way, most of my joints are damaged and I've had lots of surgery. The + or - IMO makes no difference, I keep taking the pills!

Good luck with your journey.

[Jennylaty in reply to BoneyC]

Thankyou for your reply, as you say + or - the condition still damages our joints.

[Hidden in reply to BoneyC]

Stills is a different disease now. My friend had it. We met on the rheumatology unit. We were both on the Ward together on 3 occasions and became mates.