Rheumatoid factor in healthy individuals. Rheumatoid factor in the blood

The human immune system is designed to protect against toxins, viruses and pathogens, so it always reacts to foreign particles entering the bloodstream.

A set of studies helps to determine this reaction, as well as to identify the “enemy” attacking the body and take appropriate measures, one of which is called a blood test for rheumatoid factor (RF, rheumatic factor) - let's figure out what it is and what diseases it shows.

Rheumofactor is called particles that enter the human blood from joints affected by certain diseases. Under their influence, antibodies are produced in the body, represented by predominantly immunoglobulins M.

They are aimed at fighting their own antibodies, immunoglobulins G, as a result of which a pathological process develops in the joints, tissues and blood vessels, which can lead to serious disorders. These particles can be found in laboratory conditions with the appropriate analysis.

Norms in adult women and men

This type of antibody is not found in the blood of a healthy person., but there are assumptions that are considered variants of the norm.

It primarily depends on the age of the patient: in adults values ​​from 0 to 14 IU/ml or 10 U/ml (depending on the measurement values ​​used in the laboratory) are considered normal. older man, the higher the RF level.

The significance of the increase in the diagnosis of cardiovascular diseases

It should be noted that the change in RF titer cannot be the only diagnostic sign any pathology. In such cases, the doctor refers the patient to additional research, which are designed to identify the disease with great accuracy.

Most disorders of the functioning of the cardiovascular system, which are accompanied by an increased rheumatoid factor in the blood, are a consequence of rheumatoid arthritis (with this disease, RF increases most often). These include:

RF is also found in patients with subacute - in addition to this indicator, dysproteinemia, a decrease in albumin, and an increase in the content of G and G2 globulins are observed in this case.

Other reasons if the level is elevated

High level rheumatoid factor in the blood of patients is determined for other reasons:

• Rheumatoid arthritis. With this disease this indicator increases in the vast majority of cases - in about 80% of patients. It is by the level of the rheumatic factor that one can determine the form of the disease (seropositive, seronegative), and the dynamics of the course is observed by its changes.
• Autoimmune diseases. First of all, this is Sjögren's syndrome, which is a disorder affecting the joints, lacrimal and salivary glands. In addition, RF is found in systemic lupus erythematosus, Bechterew's disease, polymyositis, scleroderma, Hashimoto's thyroiditis, etc.
• infectious diseases. These include tuberculosis, boreliosis, malaria, syphilis, mononucleosis.
• Granulomatous pathologies. This category includes diseases in which different bodies granulomas are formed - for example, pneumoconiosis, sarcoidosis and.
• Cancer diseases. An increased RF titer is observed in patients diagnosed with macroglobulinemia, a bone marrow tumor that most often consists of lymphocytes.
• Inflammatory processes localized in the liver, lungs, kidneys and musculoskeletal tissues.

It should be noted that a decrease in the RF level may also indicate the presence of the above diseases.

Rheumofactor in children

In children, the value is considered acceptable numbers not more than 12.5 U / ml.

In children, this indicator sometimes indicates juvenile rheumatoid arthritis, a disease that is typical for patients under the age of 16.

True, the RF titer in this case increases in only 20% of children under 5 years of age and in 10% of children under 10 years of age. RF can also increase in frequently ill children who have recently had viral or infectious diseases, as well as those who suffer from chronic infections, helminthic invasions, etc.

How is the analysis on the RF

The essence of the study is that if there is a rheumatic factor in the blood serum, it will react with certain antibodies. To do an analysis, a sample of venous blood is taken from the patient, and he must first observe the following rules:

What to do if you have a high level of RF in your blood? First of all Don't panic and seek professional advice, which will direct you to other studies for an accurate diagnosis.

This indicator indicates the total number of autoantibodies penetrating into the blood from damaged vascular tissues. If the test results revealed a high level, then this indicates active damage to the vascular walls.

Another rheumatoid factor is considered as a foreign protein. for which it is produced immune response organism.

This indicator increases with age and the majority of patients with a positive rheumatoid factor are the elderly. This indicates that a disease of the joints develops in the human body. Most often, women suffer from such manifestations.

Basic steps before diagnosing

To avoid false positive test results, certain rules must be followed. If the diagnosis is not carried out correctly, then the treatment will be prescribed accordingly. Which will lead to a deterioration in human health.

Basic Rules:

• Diagnosis is carried out on an empty stomach
• Only purified water is used for drinking. But before taking blood, it must be excluded.
• Alcoholic beverages and cigarettes must be excluded for 24 hours.
• The day before the analysis, you can not play sports and other types of vigorous physical activity.
• Eliminate fatty and other unhealthy foods from the diet.

Blood sampling is carried out in the laboratory by a specialist. The required volume is drawn from the cubital vein with a syringe. In addition to this diagnosis, additional tests may be prescribed to reveal the full picture of the disease.

After the doctor receives the results of the tests, he prescribes the treatment. It is carried out individually for each case.

Normal RF indicators for women

After it turned out what this indicator means, consider the following: rheumatoid factor is the norm in women by age. A table with these indicators is given below.

Small deviations from the norm should not cause concern. Experts believe that exceeding the norm by several times is a cause for concern.. There is a certain scale by which the degree of exceeding the indicator is determined:

• Minor deviation - 25-59 IU / ml
• Significant excess - 50-100 IU / ml
• Severe deviation - over 100 IU / ml

There may also be a short-term hanging of the RF, which returns to normal on its own. Similar manifestations are observed only in women who have given birth and in those who have undergone surgery.

Physiologically normal is an increase in the rate in patients whose age exceeds 60 years.

In addition, contraceptives, anticonvulsants and methyldop cause an increase in the P-factor.

But the reasons are not always in this and large indicators may indicate the presence of a serious pathology.

Rheumatoid arthritis, its types

Such a disease as rheumatoid arthritis not amenable to treatment. This type of diagnosis can determine it at the initial stages of formation. To get the maximum reliable results further diagnostics are required.

• Felty's syndrome - this pathology is not common. This is a subtype of rheumatoid arthritis. The course of the disease passes immediately in a sharp form. A complete blood count indicates leukopenia, and RF increases several times.
• Sjögren's syndrome - with similar pathology connective tissues and internal secretory glands. Symptoms of the disease are dry mucous membranes, damage to the respiratory system and kidneys.

Sometimes it happens that the rheumatoid factor remains normal, and the main symptoms of the disease are present. This may indicate the development of the first stage of the disease. For this, an additional immunological test is prescribed, which will clarify the situation.

Even slight increases in the indicator should be taken very seriously, because this may be a confirmation of the development of rheumatoid arthritis.

If the patient has a tendency to diseases of an immune nature, then prophylaxis should be carried out several times a year and at the same time a blood test should be carried out, which will confirm the patient's condition.

Other factors that lead to an increase in RF

Even if a blood test indicated the absence of RF, this is not a reliable confirmation.

Similar anomalies can occur in a woman's body during infectious diseases or acute inflammatory processes, this can provoke the development of diseases. connective tissue.

Not only rheumatoid arthritis can cause an increase in the indicator. This may lead to:

1. Acute inflammation - SARS, viral hepatitis and the like.
2. Chronic inflammation of the liver respiratory system, bones, muscles and kidneys.
3. Autoimmune pathologies that lead to damage to the glands and connective tissues. In this case, the patient feels dryness of the mucous membranes, bad job respiratory organs, heart, blood vessels and kidneys.
4. Leukopenia
5. High white blood cell count
6. Compaction and ossification of connective tissues
7. A large number of globulins in the blood serum
8. multiple myeloma
9. Lupus
10. Systemic inflammatory lung diseases
11. Surgery
12. Oncology

Inflammatory processes in the connective tissues that affect the muscles. In such patients, there is a deterioration in movements, pathology of the skin, blood vessels and other organs.

There are a lot of diseases that can increase the blood count and all of them are very dangerous for the body. Therefore, treatment must be carried out in a timely manner. It will help prevent complications. The entire diagnostic and therapeutic complex of procedures should be prescribed exclusively by a specialist, self-medication in this situation will not help. Only a doctor is able to assess the general state of health, age, medication intake and the presence of related diseases. Combine all these factors, establish an accurate diagnosis and treat.

Video: Diagnosis of rheumatoid factor, method of working with Serodia RA:

Rheumatoid factor It is a kind of antibodies, the production of which is carried out by the protective functions of the human body, that is, immunity, during the course of any pathological processes. At the same time, this type of antibody is directed against other antibodies produced by the body. These include immunoglobulins of classes E, G and A. Rheumatoid factor is a specific biochemical analysis and is one of the main laboratory tests, which makes it possible to establish in a person the presence of a disease such as RA (rheumatoid arthritis), as well as to detect other pathological processes , which include different kind acute inflammatory diseases.

The purpose of the analysis and its types

• The purpose of the analysis and its types
• Technique for the treatment of associated pathologies

Rheumatoid analysis is performed in order to detect autoantibodies in human blood plasma, which in turn belong to class M immunoglobulins. This class of immunoglobulins is the main type of antibody produced by the body's immunity, and makes up about 90% of all immunoglobulins produced. During the course of some pathological processes in the human body, this type of antibody begins to change its qualities and transforms into an autoantigen that can interact with class G antibodies.

To date, there are the following main types of laboratory tests that help determine the presence of rheumatoid factor in human blood:

1. Waaler-Rose study. This type analysis is currently used quite rarely and consists in the use of passive gluing of sheep erythrocytes, which were then treated with rabbit serum.
2. Latex test. Conducting this study allows you to effectively determine the absence or presence of RF - rheumatoid factor in women and men. However, the latex test is not able to indicate the concentration of RF in the blood. Given laboratory research is relatively inexpensive and fast, and its implementation does not require any special and expensive equipment. However, the main disadvantage of the latex test is that the study can often give false positive results, in connection with this disadvantage, such an analysis should not be the basis for establishing an accurate and final diagnosis.
3. Method of enzyme immunoassay (ELISA). This type of study is the most reliable and accurate enough, and therefore its use is widespread throughout the world.
4. Turbidimetric and nephelometric determination of RF. In terms of its reliability and accuracy of establishing the absence or presence of rheumatoid factor, it surpasses the latex test. In addition, this research technique allows not only to establish the presence of RF, but also to determine its quantitative content in human blood plasma.

In most cases, deciphering the rheumatoid factor is used in order to establish the presence of such a factor in the human body. pathological process like rheumatoid arthritis. An increase in RF concentration is observed in almost 80% of sick men and women. In this regard, rheumatoid arthritis can occur in two forms - seropositive (if RF is detected in the patient's blood) and seronegative (in the absence of rheumatic factor). If the level of rheumatoid factor is elevated, then this will indicate a progressive and intensive development of the pathological process, while its absence or a reduced level of content will indicate the course of a non-intensive inflammatory process.

Given that some people develop rheumatoid arthritis for primary stages its development may not be accompanied by the presence of RF at all, then this cannot indicate the absence of a pathological process, and therefore, to confirm the diagnosis, the patient needs to perform an additional laboratory study.

An increase in the RF level in children under 16 years of age in the presence of an intense inflammatory process in the body can be observed only in 20% of patients with rheumatoid arthritis, and in children under 10 years of age, such an increase can occur only in 10% of sick children. A high level of rheumatoid factor in the blood of a child is mainly observed if any pathologies of an infectious nature or recently transferred various inflammatory and viral diseases occur in his body. At the same time, the reason for the increased RF is by no means in the course of rheumatoid arthritis.

The main reasons provoking an increase in the level of rheumatic factor may lie in the following phenomena:

• the presence of various inflammatory pathologies of an acute course, such as syphilis, influenza, Infectious mononucleosis, viral hepatitis, and tuberculosis;
• Sjögren's syndrome, this autoimmune disease affects the connective tissue of the body and the salivary and lacrimal glands, which manifests itself in the form of impaired functioning of cardio-vascular system and respiratory organs;
• the presence of pathological processes chronic nature that affect such internal organs as the lungs, kidneys, liver and musculoskeletal system;
• development of such skin pathology as scleroderma;
• any recent surgery;
• the presence of various pathologies of an oncological nature;
• Felty syndrome, the disease is a form of rheumatoid arthritis, which is characterized by sharp decline the content of white blood cells (leukocytes) in the blood plasma, which immediately affects the RF level;
• taking certain medications.

In addition to such factors that contribute to changes in the level of rheumatic factor in the human body, there is also natural cause, due to which its norm can change, and this is due to the emergence of a process consisting in age-related changes organism occurring in the period from 60 to 70 years.

Technique for the treatment of associated pathologies

What should I do if my rheumatic factor test is positive? In the event that, after carrying out an appropriate analysis, an excess of the level of RF content was recorded in a person, then it is necessary to produce one more series of additional diagnostic procedures which will help to identify the root cause of this phenomenon.

If the reason for the increase in the RF level is the presence of such a pathological process as rheumatoid arthritis or diseases that affect the human connective tissue, then it is currently impossible to completely cure such diseases. However, with the help of appropriate treatment, it is possible to reduce the intensity of the development of the pathological process and significantly facilitate its course, which will thereby achieve a long-term remission. For such purposes, a complex course of treatment is used, which is based on the use of various anti-inflammatory drugs, broad-spectrum antibiotics and steroid hormones.

To minimize the risk of increased rheumatoid factor will help compliance simple rules, which consist in getting rid of bad habits, proper nutrition and timely treatment of existing infectious diseases.

Rheumatoid factor: what the analysis reveals, how much it costs and where to get tested

Quite often, when visiting a therapist, and especially a rheumatologist or traumatologist, you can get a referral for a blood test to determine the rheumatoid factor (rheumatoid factor, RF).

Few of the patients are familiar with this analysis and understand why it should be carried out. But this indicator in the blood can help detect various diseases still at the initial stages, which greatly simplifies the diagnosis and accelerates the cure of the disease.

Rheumatoid factor is a group of autoantibodies that have changed their properties under the influence of viruses and other agents, and react as autoantigens to their own immunoglobulins G. These autoantibodies are produced plasma cells synovial membrane, and then from the joints are in the bloodstream. In the blood, they are combined into whole immune complexes that circulate throughout the body and damage the synovial membranes and walls of blood vessels.

In another way, rheumatoid factor can be described as a protein that has changed under the influence of bacteria, viruses and other factors, and began to be perceived by the immune system as a foreign particle. In this case, the body actively produces antibodies, which are detected in a laboratory study.

The rheumatic factor is represented mainly by immunoglobulins M. At first, only the damaged joint produces it. With the course of the disease, it begins to be produced by the spleen, lymph nodes, Bone marrow, subcutaneous rheumatoid nodules.

Why is rheumatoid factor so important?

Determining the amount of rheumatoid factor makes it possible to determine the presence serious illnesses in the body. The study is used:

• for the differential diagnosis of rheumatoid arthritis and Sjögren's syndrome;
• for the diagnosis of autoimmune diseases.

Norms for women and men

Ideally, a rheumatic factor should not be detected in the blood of an adult. However, indicators from 0 to 14 IU / ml are considered the norm. Not all medical laboratories use IU/mL units, so don't be surprised if you see rheumatoid factor measured in U/mL. AT last case the norm will be up to 10 U / ml.

Even if the rheumatoid factor indicator is within the normal range, additional studies may be prescribed. After all, during the development of the disease, the samples can be negative, and be determined only when the condition worsens.

Rheumatoid factor has several stages of increase:

• slightly increased - from 25 to 50 IU / ml;
• elevated - from 50 to 100 IU / ml;
• significantly increased - more than 100 IU / ml.

Indications for analysis

Assign an analysis for a rheumatic factor in the following cases:

• suspicion of rheumatoid arthritis (soreness, swelling and redness of the joints and their stiffness after waking up);
• for the differential diagnosis of rheumatoid arthritis and other diseases of the joints;
• to check the course of therapy for rheumatoid arthritis;
• suggestion of Sjögren's syndrome;
• for diagnosing autoimmune diseases.

What does the increased content of rheumatic factor mean?

An increase in the rate of rheumatic factor in the blood may indicate the presence of various diseases:

Despite the frequent manifestation of RF in various diseases, it is most often detected in rheumatoid arthritis. This is a systemic disease with a widespread connective tissue lesion of unknown etiology. This disease mainly affects the joints. An injury, a cold, a sore throat, or other infections can start the disease.

Decreased blood levels

The absence or value of the rheumatic factor within the normal range, in the presence of symptoms of the disease, does not indicate the absence of health problems.

It is necessary to undergo additional studies and analyzes to determine the exact diagnosis. It will also require repeated tests to determine the rheumatic factor.

It is also very common for children with juvenile rheumatoid arthritis to be rheumatoid factor negative.

At increased rate one can only assume an autoimmune disease, however, other examinations will be required to determine the exact diagnosis, namely: X-ray, C-reactive protein tests and ultrasound of the affected area.

Rheumatoid factor is elevated in healthy people. On the this moment Scientists have not found an explanation for this. For example, often an increased rheumatic factor is found in women after childbirth, and over time it returns to normal.

Causes that can lead to a false positive result for rheumatic factor:

• elevated C-reactive protein during inflammation;
• antibodies to viral proteins;
• allergic reactions;
• mutation of antibodies caused by viruses.

This once again confirms that the rheumatic factor cannot be considered 100% confirmation of the presence of autoimmune diseases. In addition, the frequency of false-positive tests for rheumatic factor increases with the age of the patient.

Rheumofactor analysis

Venous blood is used to test for rheumatic factor. It is passed through a centrifuge to separate the serum, which is used directly for the study.

The analysis consists in the fact that, if present in the blood serum, the rheumatic factor will react with antibodies from the test solution. Such a test is called the Waaler-Rose or latex test. There are also express diagnostic methods - carbo-test or carbo-globulin test.

What tests should be done

In addition to the rheumatic factor analysis, other tests are also performed to establish the correct diagnosis:

• general analysis of urine and blood;
• analysis of synovial fluid;
• analysis for antinuclear bodies;
• liver tests, etc.

How to prepare for the test

As with any other biochemical blood tests, before conducting an analysis for the determination of rheumatoid factor, the following recommendations should be followed:

• One of essential conditions, which ensures the quality of laboratory tests, is fasting blood sampling in the morning (before 12:00).
• Before the analysis, approximately 12 hours before it, it is necessary to reduce physical activity Avoid smoking, alcohol and fatty foods.
• In the morning before donating blood, you can drink clean still water.
• The day before the analysis, you should exclude the use of drugs. If this is not possible, then it is necessary to inform the laboratory assistants about all the drugs taken.

The cost of the service for determining this indicator

You can take an analysis to determine the rheumatic factor in almost any laboratory. The average cost of this service is 450-600 rubles.

How to normalize the content of the rheumatic factor

What to do if the rheumatoid factor in the blood is elevated? The most important thing is not to panic. It is very important to consult with the attending physician, who will select the appropriate treatment. After all, the goal is not to reduce the factor, but to start treating the disease that provoked its increase.

If rheumatoid arthritis or other connective tissue disease is confirmed, then complete cure impossible. However, it is quite possible to alleviate the condition and slow down the progression of such diseases. For this, complex treatment is used with the use of antibacterial and anti-inflammatory drugs, as well as steroid hormones.

When the patient's condition improves and the signs of the disease decrease, the rheumatoid factor can be determined for some time during laboratory tests.

In any case, for any alarms from your body and suspected of any disease, you should seek quality medical care from qualified specialist. Self-medication is not worth it. Untimely therapy can lead to serious consequences, as well as the transition of diseases to a chronic form.

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Analysis for ACCP in rheumatoid arthritis: norm, interpretation in women and men

AT last years there is a trend towards an increase in the number of diseases musculoskeletal system, with more and more cases of diseases in children being recorded. One such common disease is rheumatoid arthritis, which occurs in both men and women. Moreover, women tend to get sick in more early age. Moreover, women get sick almost three times more often than men. Start timely treatment will prevent the occurrence of complications and ensure a positive result. The analysis for ACCP in rheumatoid arthritis plays an essential role in the diagnosis. Consider the essence of this test, what is its norm and when it needs to be done.

The essence of the ACCP test

Rheumatoid arthritis is systemic disease. It has a damaging effect on the articular connective tissue. Its main manifestation is the occurrence of chronic inflammation of the joints. Rheumatoid arthritis begins with inflammation of the synovial membrane, which leads to the fact that gradually the cartilage tissue is destroyed and the joint is deformed. If this type of arthritis is not diagnosed in time, the consequences can be very serious. In particular, the joint will be deformed, which will lead to a violation of its mobility, and as a result, the person will become disabled.

The ACCP test has become a cutting-edge discovery for the diagnosis and positive course of rheumatoid arthritis.

To diagnose arthritis, you need to know what is the concentration of two antibodies in the body:

• ACCP (cyclic citrulline peptide antibodies);
• RF (rheumatoid factor).

The analysis of ACCP in rheumatoid arthritis gives an accurate result, and the decoding of the test makes it possible to determine the pathological process on early stage. As for the test for rheumatoid factor, it is quite specific and its reliability is largely determined by the duration of the disease. In about 50% of cases, the result is positive within 6 months from the onset of the disease, and in 85% the result will be positive within 2 years from the onset of the disease.

The essence of the test is to determine the content of antibodies in the patient's blood relative to the cyclic citrulline peptide. This peptide is involved in normal exchange substances. The formation of citrulline is promoted by arginine, which is an amino acid.

If there is damage to the joints in the body, then citrulline begins to integrate into the protein chain. For the immune system, the peptide, which includes citrulline, is foreign, and therefore it begins to produce antibodies against it.

Rheumatoid factor is detected if the liver is affected, if there is oncology or a severe stage of tuberculosis.

Benefits of the ACCP test

This analysis of blood serum is one of the most accurate, since it can be used to identify the disease on initial stage when there are no visible symptoms.

ACCP has the following advantages over rheumatoid factor:

• Allows you to determine rheumatoid arthritis at the initial stage - 70%;
• Allows you to identify the stage of progression of the disease - 79%;
• The accuracy of the results is 98%;
• Predicts in what way the disease will develop, which makes it possible to prescribe timely and positive treatment;
• Thanks to the test, antibodies to ACCP can be detected even before the first symptoms appear.

Preparation for the analysis of ACCP and the procedure itself

To conduct the test, the patient must comply with a number of rules:

1. The analysis is done on an empty stomach (the last meal should be 8-12 hours before the analysis).
2. During the day you can not drink liquid.
3. No smoking.

ACCP analysis procedure

For the test, blood is taken from a vein, after which serum is extracted from it, which is used to obtain the necessary information. For this purpose, the blood is placed in a special centrifuge. The indicator will be accurate if it is made from fresh whey, but frozen whey can also be used. The second option is widely used due to the workload of laboratories. Serum can be stored frozen at -200 degrees for a week.

Serum must not be thawed and refrozen as this will affect the accuracy of the test. When carrying out the analysis, the cytofluometry method is used: the serum is translucent with a laser. The nature of the beam scattering allows you to determine the content of ACCP in the serum.

The analysis for ACCP is simple and painless for the patient, however, it is characterized by a rather high price. Depending on the laboratory, the price ranges from 1000-1700 rubles. Also, the urgency of the results can affect the price.

ACCP norm

The test norm is the same for women and men, as well as for different ages and is 3-3.1 U / ml.

However, in some cases it may change:

• For women - 3.8 - 4 U / ml;
• For the elderly - an increase to 2 units;
• For children with unformed skeletal system- 2.7 - 2.7 U / ml.

How to decipher your analyzes and identify the onset of rheumatic processes, as well as diagnose other ailments:

Joint treatment More >>

Deciphering helps the doctor to create an effective treatment plan. At the end of treatment, a second test is prescribed, the indicators of which should return to normal. If this does not happen, then treatment continues until the result is positive.

Decryption:

• Norm 0 - 20 U / ml - negative value;
• 20.0 - 39.9 U / ml - the test is weakly positive;
• 40 - 59.9 U / ml - the test is positive;
• More than 60 U / ml - the test is positive, strongly pronounced.

According to the interpretation, an indicator of 20 U / ml is considered normal, in fact, more and more specialists are inclined to believe that it is possible to exclude arthritis by 100% only when the result is zero.

Thus, ACCP in rheumatoid arthritis is the most important test to help diagnose rheumatoid arthritis at an early stage. The analysis can show a positive result, even before external manifestations illness. The result is considered positive if, when deciphered, the indicator is more than 20 U / ml. positive analysis makes it possible to start treatment of arthritis in a timely manner, and prevent the occurrence of serious consequences of this disease.

Polymorphic rash
In juvenile arthritis, the rash appears at the height of the fever. Then it may periodically appear and disappear. However, it is not accompanied by itching or other unpleasant sensations. The nature of the rash can be very diverse.

Rash in juvenile rheumatoid arthritis is of the following types:

• patchy rash;
• rash in the form of urticaria;
• hemorrhagic rash;
• papular rash.

Heart failure
In juvenile rheumatoid arthritis, both the heart muscle and the membranes that cover the heart can be affected. In the first case, the disease proceeds in the form of myocarditis. Myocarditis is accompanied by weakness and inferiority of cardiac activity. The heart, which normally functions as a pump in the body ( pumps blood throughout the body), in this case, is not able to provide oxygen to the entire body. Children complain of weakness, shortness of breath, fatigue.
Also, with rheumatoid arthritis, the pericardium can also be damaged with the development of pericarditis. Involvement in the pathological process of both the heart muscle and the pericardium is called myopericarditis.

Lung injury
Lung damage can occur in the form of sclerosing alveolitis or pleurisy. In the first case, the walls of the alveoli are replaced by connective tissue. As a result, the elasticity of the alveoli and the lung tissue decreases. In the case of pleurisy, effusion accumulates in the pleural cavity ( inflammatory fluid), which gradually compresses the lung. In both the first and second cases, the main symptom is shortness of breath.

Hepatolienal syndrome
Hepatolienal syndrome is characterized by an enlarged liver and spleen. More often, only the liver is enlarged ( hepatomegaly), which is manifested by dull aching pain in the right hypochondrium. If the spleen also enlarges ( splenomegaly), then the pain also appears on the left. However, in young children, any abdominal pain is localized around the navel. Therefore, it is possible to identify an enlarged liver and spleen only when medical examination during palpation.

Lymphadenopathy
Lymphadenopathy is called enlarged lymph nodes. Those nodes that are localized near the inflamed joint increase. If the temporomandibular joints are affected, then the cervical and submandibular nodes increase; if the knee joint - then the popliteal nodes. Thus, lymphadenopathy is reactive, and not specific.

Juvenile rheumatoid arthritis can occur in several ways:

• oligoarticular variant- with damage to two - three, but not more than four joints;
• polyarticular variant- with damage to more than four joints;
• system variant- with damage to both internal organs and joints.

What are the first symptoms of rheumatoid arthritis?

The first symptoms of rheumatoid arthritis are:

• symptoms of general intoxication of the body;
• symptoms of joint lesions;
• symptoms of extra-articular lesions.

Symptoms of general intoxication of the body in rheumatoid arthritis are:

• general fatigue;
• weakness in the whole body;
• weakness;
• aches in all joints and bones;
• aching pain in muscles that can persist for a long time;
• pallor of the skin of the face and limbs;
• cold hands and feet;
• sweating of the palms and feet;
• decreased or loss of appetite;
• weight loss;
• elevated body temperature up to 37.5 - 38 degrees;
• chills;
• enlargement of peripheral lymph nodes.

Symptoms of joint lesions
The main manifestations of rheumatoid arthritis are joint damage. In the initial stage of the disease, articular symptoms are caused by an active inflammatory process in the joints and the resulting periarticular ( periarticular) edema.

The first symptoms of articular lesions in rheumatoid arthritis are:

• morning stiffness;
• decrease in range of motion.

Articular lesions in rheumatoid arthritis

Nonspecific symptoms of joint inflammation in rheumatoid arthritis are:

• joint pain on palpation feeling);
• swelling of the joint and tendons attached to it;
• an increase in local temperature;
• sometimes slight redness skin around the joint.

Joint pain
Joint pain in rheumatoid arthritis are constant, aching. A small physical load and even ordinary movements in the joints cause increased pain. After a warm-up or by the end of the working day, the pain tends to ease. Relief lasts no more than 3-4 hours, after which the pain intensifies again. To reduce pain, the patient involuntarily holds the affected joint in a bent position.

Decreased range of motion
Due to periarticular edema and pain in the inflamed joints, the range of motion decreases. This is especially noticeable with the defeat of the metacarpophalangeal and interphalangeal joints of the hands. Patients with rheumatoid arthritis have difficulty with fine motor skills of the hands. It becomes difficult for them to fasten buttons, thread a needle, and hold small objects.

Symptoms of extra-articular lesions
Usually, in rheumatoid arthritis, symptoms of extra-articular lesions appear in the later stages of the disease. However, some of them can be observed along with the first articular symptoms.

Symptoms of extra-articular lesions that may appear early in the disease are:

• subcutaneous nodules;
• muscle damage;
• vasculitis ( vascular inflammation) skin.

Muscle damage
Muscle weakness is often one of the first symptoms of rheumatoid arthritis. Muscles near inflamed joints atrophy and decrease in size.

Skin vasculitis
Cutaneous vasculitis appears in the distal areas of the arms and legs. On the nails and fingertips you can see many brown dots.
rheumatoid arthritis, which debuts with joint damage lower extremities, sometimes accompanied by severe vasculitis in the form of skin ulcers on the legs.

What are the stages of rheumatoid arthritis?

The clinical stages of rheumatoid arthritis are:

• first stage- manifested by swelling of the synovial bag of the joint, which causes pain, local temperature and swelling near the joint;
• second stage- cells of the synovial membrane under the influence of inflammatory enzymes begin to divide, which leads to compaction of the articular bag;
• third stage- deformity of the joint or joints) and loss of mobility.

• Early stage lasts the first six months. At this stage, there are no main symptoms of the disease, but it is manifested by periodic fever and lymphadenopathy.
• Expanded stage– lasts from six months to two years. It is characterized by extensive clinical manifestations- there is swelling and pain in the joints, there are changes in some internal organs.
• late stage - two years or more after the onset of the disease. Complications begin to develop.

• Stage of early radiological changes- characterized by compaction of soft tissues and the development of periarticular osteoporosis. On x-ray film, this looks like increased transparency of the bone.
• Stage of moderate radiological changes- characterized by an increase in osteoporosis and the addition of cystic formations in the tubular bones. Also at this stage joint space starts to shrink.
• Stage of pronounced radiological changes- manifested by the presence of destructive changes. A feature of this stage is the appearance of deformities, dislocations and subluxations in the inflamed joints.
• Ankylosis stage- consists in the development of bone growths ( ankylosis) in the joints, usually in the joints of the wrists.

What are the types of rheumatoid arthritis?

The types of rheumatoid arthritis are:

• polyarthritis- simultaneous damage to more than four joints;
• oligoarthritis- simultaneous inflammation of 2 - 3 joints, maximum - 4;
• monoarthritis- inflammation of one joint.

Felty syndrome
Felty's syndrome is a special variant of rheumatoid arthritis, which is characterized by damage to both joints and internal organs. Manifested severe defeat joints, enlargement of the liver and spleen, and vascular inflammation ( vasculitis). Felty's syndrome is especially severe due to the presence of such a symptom as neutropenia. With neutropenia, white blood cells decrease, which is why there is a constant risk of infectious complications.

Still's disease
In Still's disease, arthritis is accompanied by recurrent fever and rash. The temperature fluctuates between 37 - 37.2 degrees. At the same time, it periodically appears and disappears, that is, it recurs. The rash in Still's disease is large-spotted or papular. Rheumatoid factor is negative.

Another variant of rheumatoid arthritis is juvenile rheumatoid arthritis. This type of arthritis occurs in children and adolescents under 16 years of age. It is characterized by both articular and extra-articular manifestations. Of the extra-articular symptoms, keratoconjunctivitis, scleritis, rheumatoid nodules, pericarditis, and neuropathies are more common. Children with juvenile arthritis often lag behind in physical development.

What are the degrees of activity of rheumatoid arthritis?

The components of the DAS index are:

• general well-being of the patient according to the visual analog scale;
• the number of swollen joints;
• the number of painful joints according to the RICHIE index;
• ESR ( ).

There is the following interpretation of the DAS index:

• low activity at DAS less than 2.4;
• moderate activity at DAS from 2.4 to 3.7;
• high activity with DAS of 3.7 or more.

Rheumatoid arthritis activity can also be assessed by the Larsen method. This is an X-ray method that takes into account the presence and depth of destructive changes. Larsen identified six degrees of change - from 0 ( norm) until 6 ( the degree of pronounced destructive changes). Also relevant is the HAQ indicator, which takes into account the degree of functional changes.

In everyday practice, the doctor is more often guided by functional classes. Functional classes reflect both the degree of activity of the pathological process and its correlation with the daily activities of the patient.

There are the following functional classes of rheumatoid arthritis:

• 1 class- all movements in all joints are preserved without restriction;
• Grade 2– mobility is preserved when performing daily loads;
• 3rd grade– the ability to perform daily activities is limited;
• 4th grade- Unable to carry out daily activities.

What tests should be taken for rheumatoid arthritis?

Among the laboratory tests that are prescribed for rheumatoid arthritis, two main groups can be distinguished:

• standard analyses;
• specific blood tests.

The standard tests for rheumatoid arthritis are:

• hemoleukogram ( general blood analysis);
• ESR ( sedimentation rate of erythrocytes);
• blood test for C-reactive protein;
• detection of rheumatoid factor.

Pathological changes in the hemoleukogram in rheumatoid arthritis

Typically, mild leukocytosis and mild anemia are seen in rheumatoid arthritis. The more acute and severe the course of rheumatoid arthritis, the greater the number of leukocytes in the blood.
When especially severe course diseases, when the inflammatory process affects the spleen, neutropenia and thrombocytopenia are noted.

ESR
In rheumatoid arthritis, the rate of erythrocyte sedimentation to the bottom of the tube is examined. An active inflammatory process causes an increase in this rate of more than 15 millimeters per hour. With adequate treatment and regression of the disease, the erythrocyte sedimentation rate decreases.

Blood chemistry
A biochemical blood test is done to detect an increase in protein synthesis, which indicates the active phase of inflammation.

The main pathological changes in the biochemical blood test in rheumatoid arthritis

Blood test for C-reactive protein
In rheumatoid arthritis, a blood test is required to detect C-reactive protein. This protein is produced actively in the first 24-48 hours from the onset of the inflammation process. The amount of C-reactive protein in the blood indicates the severity of inflammation and the risk of disease progression. In rheumatoid arthritis, the amount of C-reactive protein is more than 5 milligrams per liter of blood.

Identification of rheumatoid factor.
More than 75 percent of patients with rheumatoid arthritis have a positive reaction to rheumatoid factor. In the midst of his illness, his credits ( levels) increase from 1:32.

Rheumatoid factor is a special immune complexes that are formed in the body during severe inflammatory reactions. During inflammation, lymphocytes are damaged ( immune cells blood) that continue to synthesize immune proteins. The body takes these proteins for foreign particles and produces rheumatoid factor against them.

Specific blood tests
Specific blood tests that are prescribed for rheumatoid arthritis indicate the presence of specific markers of the disease.

Specific blood tests are:

• detection of antibodies to cyclic citrulline peptide ( anti-SSR);
• detection of antibodies to modified citrullinated vimentin ( anti-MCV).

Determination of antibodies to modified citrullinated vimentin
Antibodies to modified citrullinated vimentin are considered the most specific markers in the diagnosis and monitoring of rheumatoid arthritis.
Under the action of various inflammatory enzymes in damaged cells, in addition to citrulline, another special protein is synthesized - modified citrullinated vimentin. The highest concentration of this substance is found in the synovial ( articular) liquids. The immune system of the body produces a large number of antibodies to MVC, which can be found in the peripheral blood.

An anti-MCV test can diagnose rheumatoid arthritis with 99 to 100 percent accuracy.

What is systemic rheumatoid arthritis?

Any organ or organ system can be affected.

Systemic manifestations of rheumatoid arthritis are:

• from the cardiovascular system- myocarditis, pericarditis, myopericarditis, vasculitis, in rare cases, granulomatous valvular lesions;
• from the respiratory system- Kaplan's syndrome presence of rheumatoid nodules in the lungs), bronchiolitis, damage to the interstitium of the lungs;
• from the side nervous system - neuropathy ( sensory or motor), mononeuritis, cervical myelitis;
• from the lymphatic system- lymphadenopathy;
• from the urinary system- kidney amyloidosis, nephritis;
• from the skin- rheumatoid nodules, livedo reticularis, thickening of the skin, multiple microinfarctions in the area of ​​the nail bed;
• by the organs of vision- keratitis, conjunctivitis, episcleritis;
• from the blood system anemia, thrombocytosis, neutropenia.

Other manifestations of systemic rheumatoid arthritis are:

• arthritis of the knee joints followed by hallux valgus;
• arthritis of the foot joints with deformity of the big toe and subluxation of the metatarsophalangeal joints;
• arthritis cervical region spine with subluxation in the atlantoaxial joint ( joint of the first and second cervical vertebra ) and compression vertebral artery;
• damage to the ligamentous apparatus - with the development of bursitis and tendosynovitis, as well as the formation of synovial cysts ( for example, a Baker's cyst on the back of the knee);
• the appearance of rheumatoid nodules around the affected joints;
• recurrent subfebrile ( 37 - 37.2 degrees) temperature;
• morning stiffness in the joints;
• soreness of the affected joints;
• decreased strength in the limbs;
• polymorphic rash, in adults - rarely, in children - more often;

How is rheumatoid arthritis treated?

Therapeutic approaches for rheumatoid arthritis are:

• drug therapy;
• physiotherapy;
• Spa treatment;
• maintaining a certain lifestyle.

The types of drug treatment are:

• anti-inflammatory therapy;
• basic therapy;
• local therapy.

Basic therapy
The drugs on the basis of which basic therapy is carried out are the main ones in the treatment of polyarthritis. These medicines affect main reason diseases. Such treatment does not give a quick result and the onset positive effect maybe not earlier than a month later. With properly selected drugs, basic therapy allows achieving stable remission in most patients.

Local therapy
Topical treatment is an adjunct to the main therapy for rheumatoid arthritis.

Types of local treatment are:

• Applications based on drugs- contribute to the reduction of inflammatory processes and have an analgesic effect.
• Rubbing ointments and gels- rubbed into the area of ​​the affected joint, helping to smooth out the symptoms of the inflammatory process. Such treatment is effective in the initial stages of the disease.
• The introduction of drugs by the intraarticular method- allows you to influence directly the affected joints. Various drugs, biologically and chemically active substances are used for treatment.

The types of physiotherapy are:

• electrophoresis- the introduction of drugs through the skin using an electric current;
• phonophoresis- injection of drugs through the skin with ultrasound;
• ultraviolet irradiation- impact on the affected areas with ultraviolet waves of different waves;
• darsonvalization– the procedure is based on the application of pulsed current;
• diathermy- heating the diseased joint with electric current;
• ozokerite– thermal compresses based on a natural resource;
• cryotherapy- general or local exposure to cold;
• laser therapy– application in medicinal purposes light energy.

Surgery
Surgical treatments are used to preserve, restore or improve joint function. At an early stage of the disease, preventive treatment, during which the shell of the affected joints is excised. In the presence of persistent deformities in the joints, the patient is shown reconstructive surgery. In the course of such manipulations, along with excision of the membrane, the altered sections of the articular tissue are removed. It can also simulate new articular surfaces, replacement separate parts joint implants, limitation of joint mobility.

Spa treatment
Sanatorium-and-spa treatment is indicated when the patient's condition improves in order to fix the achieved results in the course of treatment. The most effective resorts, where the emphasis is on mineral baths.

• salt;
• radon;
• hydrogen sulfide;
• iodine-bromine.

• dieting;
• overweight prevention;
• restriction of tobacco and alcohol-containing products;
• timely rest;
• prevention of infectious diseases;
• practicing permitted sports swimming, aerobics, walking).

What medicines are used in the treatment of rheumatoid arthritis?

In the treatment of rheumatoid arthritis, the following groups of drugs are used:

• non-steroidal anti-inflammatory drugs ( NSAIDs);
• glucocorticoids ( GC);
• immunosuppressants;
• antimetabolites.

Drugs used in the treatment of rheumatoid arthritis

After 20 years from the onset of the disease, 50 to 80 percent of patients lose their ability to work.

The main principles of treatment of rheumatoid arthritis are as follows:

• the main goal of treatment is to achieve remission, complete or partial;
• treatment is carried out under the strict supervision of a rheumatologist and a family therapist;
• intravenous injections, droppers with basic treatment drugs are carried out only in a hospital under the supervision of a doctor;
• Monotherapy is preferred single drug treatment), and only in case of inefficiency they switch to combination therapy;
• in parallel, prevention of complications is carried out ( infectious, cardiovascular complications, anemia);
• NSAID therapy is carried out simultaneously with basic treatment;
• treatment with basic drugs is prescribed as early as possible; basic therapy is recommended to start within three months from the onset of the first symptoms;
• the effectiveness of the undertaken treatment method is assessed according to international standards.

Diet rules for rheumatoid arthritis are:

• exclusion of products that cause allergies;
• replacing meat with dairy herbal products;
• inclusion enough fruits and vegetables;
• reducing the burden on the kidneys, liver and stomach;
• consumption of foods with high content calcium;
• refusal of food that causes excess weight.

Allergenic foods include:

• citrus ( oranges, grapefruits, lemons, tangerines);
• whole milk ( cow, goat);
• cereals ( rye, wheat, oats, corn);
• nightshade crops ( tomatoes, potatoes, peppers, eggplant).

Replacing meat with dairy and plant products
According to medical statistics, about 40 percent of patients with rheumatoid arthritis report an improvement in their condition when they refuse meat. Therefore, especially during an exacerbation of the disease, it is necessary to completely exclude or limit as much as possible the use of dishes that include the meat of any wild or domestic animals.

Compensate for the lack of meat in the diet is necessary products, which include a large amount of protein. In the absence of allergies, dairy products can become a source of protein. You should also consume a sufficient amount of fatty fish.

• legumes ( beans, chickpeas, lentils, soy);
• eggs ( chicken, quail);
• nuts ( almond, peanut, hazelnut, walnut);
• vegetable oils ( olive, linseed, corn);
• fish ( mackerel, tuna, sardine, herring).

Herbal products that are useful for consumption are:

• broccoli;
• Brussels sprouts;
• carrot;
• pumpkin;
• zucchini;
• leaf salad;
• avocado;
• apples;
• pears;
• strawberries.

Foods to be excluded are:

• hot spices, flavor enhancers, food additives;
• canned factory products;
• rich broths;
• butter, margarine, lard;
• cocoa, chocolate;
• strongly brewed coffee and tea;
• carbonated drinks.

Eating foods high in calcium
Drugs taken during treatment for rheumatoid arthritis lead to calcium deficiency, which can cause osteoporosis ( brittleness and loss of density bone tissue ). Therefore, the diet of patients should include foods that are rich in this element.

Sources of calcium are:

• dairy;
• soy products;
• legumes ( beans);
• nuts ( almond, Brazil nut);
• seeds ( poppy, sesame);
• leafy greens ( parsley, lettuce, arugula).

Refusal of foods that cause excess weight
Patients with rheumatoid arthritis limit their physical activity, resulting in excess weight. Excess body weight puts stress on inflamed joints. Therefore, the diet of such people should contain a reduced amount of calories. To do this, it is necessary to reduce the amount of refined carbohydrates consumed, which are found in sugar, flour and refined vegetable oil. You should also limit your food intake high content fats.

High calorie foods are:

• pizza, hamburgers, hot dogs;
• muffins, cakes, pastries;
• powdered and carbonated drinks;
• chips, crackers, french fries;
• marmalade, jam, jams.

What are the complications of rheumatoid arthritis?

Complications of rheumatoid arthritis are:

• damage to the joints and the musculoskeletal system;
• skin lesions;
• eye diseases;
• pathologies of the cardiovascular system;
• dysfunction of the nervous system;
• respiratory system damage;
• dysfunction of the gastrointestinal tract;
• mental disorders;
• other pathologies.

Musculoskeletal disorders are:

• pathological changes in muscle tissue due to malnutrition;
• bursitis ( inflammation of the joint capsules);
• tendinitis ( inflammation of the tendons);
• synovitis ( inflammation of the lining of the joints);
• damage to the joints located in the larynx ( causes shortness of breath, bronchitis, voice change).

Others skin problems with this disease are:

• thickening or depletion of the skin;
• digital arteritis ( small necrosis in the nail bed);
• mesh livedo ( highly translucent blood vessels due to thinning of the skin);
• cyanotic color of the skin of the fingers and feet;
• gangrene of the fingers.

Pathologies of the cardiovascular system
In rheumatoid arthritis in many patients between the pericardium ( shell of the heart) and fluid accumulates in the heart, leading to pericarditis ( inflammation of the pericardium). In some cases, an inflammatory process may develop in middle shell hearts ( myocarditis). Rheumatoid arthritis increases the likelihood of diseases such as heart attack and stroke. Another dangerous complication of this type of arthritis is inflammation of the small blood vessels.

Nervous system dysfunction
As a result of compression of the nerve trunks in the joints, patients develop pain in the lower and upper limbs that get worse at night.

Other disorders of the nervous system are:

• paresthesia ( sensory disturbance);
• burning, chilliness of hands and feet;
• movement disorders;
• muscular atrophy;
• cervical myelitis ( inflammation of the cervical spine).

Respiratory system lesions
Inflammatory process in rheumatoid arthritis can cause pleurisy ( inflammation of the lining surrounding the lungs). In some cases, rheumatoid nodules may develop in the lungs. These growths sometimes lead to lung infections, coughing up blood, and accumulation of fluid between the chest and the lining of the lungs. This form of arthritis can also cause pulmonary hypertension and interstitial lung disease ( peptic ulcer of the stomach or duodenum. Periodically, complications such as gastrointestinal bleeding may occur.

Mental disorders
One of the complications of rheumatoid arthritis, which manifests itself in mental level, is depression. The need for the systematic use of potent drugs, restrictions and the inability to lead a normal life cause negative changes in the patient's emotional background. According to statistics, 11 percent of patients have signs of depression in moderate or severe form.

Other pathologies

Diseases that provoke rheumatoid arthritis are:

• splenomegaly ( enlargement of the spleen);
• peripheral lymphadenopathy ( enlargement of peripheral lymph nodes);
• autoimmune thyroiditis ( autoimmune thyroid disease).

What is the prognosis for rheumatoid arthritis?

Causes of an unfavorable prognosis

The reasons that adversely affect the prognosis include:

• the female gender of the patient;
• young age;
• exacerbation lasting at least 6 months;
• inflammation of more than 20 joints;
• seropositive test for rheumatoid factor at the onset of the disease;
• increased erythrocyte sedimentation rate;
• high concentration of C-reactive protein ( substance that is an indicator of inflammation) in blood serum;
• a large amount of haptoglobin ( a protein formed in the acute phase of inflammation) in plasma;
• carriage of HLA-DR4 ( antigen indicating a predisposition to a severe course of the disease and low susceptibility to basic drugs).

Every year, from the total number of patients with this disease, from 5 to 10 percent of patients become disabled. After 15-20 years from the onset of the disease, the vast majority of patients are diagnosed with a severe stage of rheumatoid arthritis, which is accompanied by immobility of individual joints.

Death in rheumatoid arthritis
Death in rheumatoid arthritis ends in about 15 - 20 percent of cases. Death occurs due to infectious processes ( pneumonia, pyelonephritis), pathologies of the gastrointestinal tract ( bleeding, perforation), cardiovascular accidents ( heart attack, stroke). Agranulocytosis is a common cause of death in rheumatoid arthritis ( a condition in which the level of white blood cells in the blood decreases) against which strong septic and purulent processes develop.

Syndrome of chronic pelvic pain. Causes, symptoms, mechanisms of development, diagnosis, principles of treatment of the disease.

Rheumatoid factor is a specific marker of autoimmune diseases. chemical structure is an immunoglobulin of class M. This substance is produced in response to the penetration into the body of a specific bacterium - beta-hemolytic streptococcus (the most common cause).

The etiology of the appearance of rheumatoid factor in the blood

Rheumatoid factor in the blood is found in only 20% of people after infection with beta-hemolytic streptococcus. Why is the substance not detected in all people? Modern science has not yet found the answer to this question. However, the reason for the appearance of autoimmune diseases, in which immunity destroys body tissues, has not been explained.

True, scientists have not yet precisely determined what an antirheumatoid factor is. In some literary sources it is written that this is a group of antibodies. In other specialized articles, you can read that the rheumatic factor is a protein that has acquired new properties under the influence of viruses or bacteria.

It is logical to assume that if it appears after streptococcal infections, then it is this bacterium that provides the mutation.

There is a theory stating that this substance is produced in the presence of a large number various antibodies (immunoglobulins). For example, in older people whose body has met with large quantity different microbes and developed specific protection against them (immunoglobulins). It is for this reason that after the age of 60, the number of patients with a positive result for rheumatic factor increases.

Tip: Sore throats should be treated as early as possible. Statistics show that rheumatoid arthritis occurs in people most often after these diseases.

What is rheumatoid factor determined for?

• Diagnosis of autoimmune conditions (in combination with c-reactive protein and ESR);
• Diagnosis of Sjögren's syndrome and rheumatoid arthritis. In these conditions, the rheumatic factor is increased.

In both diseases, autoimmune damage to one's own tissues occurs. With rheumatoid arthritis inflammatory changes joints. With Sjögren's disease - damage to the connective tissue of the endocrine glands.

A quantitative determination of the value of this substance is not carried out, therefore, according to the laboratory result, one can only judge whether the norm or pathology in the blood. True, a negative analysis for rheumatic factor does not mean the absence of the disease. There are seronegative forms of rheumatoid arthritis, in which the substance is not detected in the blood, but there may be a significant increase in many joints (polyarthritis) against the background of the formation of antibodies.

Rheumofactor: normal or elevated

Rheumatoid factor is normal - from 0 to 14 IU / ml. If the indicator is elevated, an autoimmune disease can be assumed, but an additional examination is needed to make an accurate diagnosis:

• Ultrasound scanning of the affected area;
• Radiography of the limb;
• Laboratory tests for C-reactive protein.

Only the clinical norm, in which there is no pathological symptoms, no rheumatoid factor is detected and no abnormalities appear in other laboratory tests, may indicate the absence of an autoimmune reaction in a person. However, even with the slightest changes in the articular surfaces, the doctor should check for the absence of a rheumatic factor in order to exclude rheumatoid damage.

Attention! Rheumatoid factor can be elevated in healthy people. Such situations occur, although scientists have not explained the essence of the appearance of antistreptococcal immunoglobulins. Sometimes blood tests show a positive result in women after childbirth. In such situations physiological state blood normalizes on its own after a while.

Why does a healthy person not have a norm (false positive result) when determining a rheumatic factor:

• The presence of antibodies to certain viral proteins (for example, in carriers of hepatitis);
• Increased C-reactive protein during inflammation;
• Mutation of antibodies under the influence of the virus;
• Allergic reactions.

Thus, rheumatoid factor cannot be called an absolute marker of autoimmune diseases.

How is rheumatoid factor tested?

An analysis of the rheumatic factor is performed if a person is suspected of having antibodies to articular tissues, when symptoms of inflammation of the joint are observed. Sometimes an analysis is prescribed if women do not have a sore throat for a long time after childbirth. In such a situation, it is possible to prevent rheumatoid arthritis in the early stages.

A test for the determination of rheumatic antibodies in medicine is called the "Waaler-Rose" (carbo test, latex test). Its essence lies in the adsorption of class M immunoglobulins on the latex and staining them with chemical reagents.

How to prepare for a rheumatic factor test:

• Do not eat before analysis;
• Do not smoke;
• You can drink only clean water;
• Exclude physical exercises;
• Do not eat fatty foods the day before the test.

Don't be alarmed if your rheumatoid factor is slightly elevated. This result may be physiological characteristics organism. The absolute norm in medicine is not achievable, so doctors believe that healthy people do not exist (there are those who have not been examined). Health to you!

What to do if you are still diagnosed with the disease? The doctors give the answers in the video: