Claim: Blood Test May Predict Rheumatoid Arthritis
Verdict: REFUTES

Retrieved passages:
title: Rheumatoid arthritis
text: in assessing the degree of synovial inflammation as they can show vascular signals of active synovitis. This is important, since in the early stages of RA, the synovium is primarily affected, and synovitis seems to be the best predictive marker of future joint damage. When RA is clinically suspected, a physician may test for rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPAs measured as anti-CCP antibodies). It is positive in 75-85%, but a negative RF or CCP antibody does not rule out RA, rather, the arthritis is called "seronegative", which is in about 15-25% of people with RA. During the

title: Juvenile idiopathic arthritis
text: causes. No single test can confirm the diagnosis, and most physicians use a combination of blood tests, X-rays, and clinical presentation to make an initial diagnosis of JIA. The blood tests measure antibodies and the rheumatoid factor. Unfortunately, the rheumatoid factor is not present in all children with JIA. Moreover, in some cases, the blood work is somewhat normal. X-rays are obtained to ensure that the joint pain is not from a fracture, cancer, infection, or congenital abnormality. In most cases, fluid from the joint is aspirated and analyzed. This test often helps in making a diagnosis of JIA by

title: Rheumatoid factor
text: between rheumatoid factor and more persistently active synovitis, more joint damage, greater eventual disability and arthritis. Other than in rheumatoid arthritis, rheumatoid factor may also be elevated in: The test was first described by Norwegian Dr Erik Waaler in 1940 and redescribed by Dr Harry M. Rose and colleagues in 1948. Redescription is said to be due to the uncertainties due to World War II. It is still referred to as the Waaler-Rose test. Rheumatoid factor Rheumatoid factor (RF) is the autoantibody that was first found in rheumatoid arthritis. It is defined as an antibody against the Fc portion of

title: Rheumatoid arthritis
text: started. The by far most common clinical test for ACPAs is the anti-cyclic citrullinated peptide (anti CCP) ELISA. In 2008 a serological point-of-care test for the early detection of RA combined the detection of RF and anti-MCV with a sensitivity of 72% and specificity of 99.7%. Other blood tests are usually done to differentiate from other causes of arthritis, like the erythrocyte sedimentation rate (ESR), C-reactive protein, full blood count, kidney function, liver enzymes and other immunological tests (e.g., antinuclear antibody/ANA) are all performed at this stage. Elevated ferritin levels can reveal hemochromatosis, a mimic of RA, or be a

title: Rheumatoid arthritis
text: first year of illness, rheumatoid factor is more likely to be negative with some individuals becoming seropositive over time. RF is a non-specific antibody and seen in about 10% of healthy people, in many other chronic infections like hepatitis C, and chronic autoimmune diseases such as Sjögren's syndrome and systemic lupus erythematosus. Therefore, the test is not specific for RA. Hence, new serological tests check for anti-citrullinated protein antibodies ACPAs . These tests are again positive in 61-75% of all RA cases, but with a specificity of around 95%. As with RF, ACPAs are many times present before symptoms have

title: Rheumatoid factor
text: immunoglobulins, i.e. IgA, IgG, IgM, IgE, IgD. RF is often evaluated in patients suspected of having any form of arthritis even though positive results can be due to other causes, and negative results do not rule out disease. But, in combination with signs and symptoms, it can play a role in both diagnosis and disease prognosis. It is part of the usual disease criteria of rheumatoid arthritis. The presence of rheumatoid factor in serum can also indicate the occurrence of suspected autoimmune activity unrelated to rheumatoid arthritis, such as that associated with tissue or organ rejection. In such instances, RF

title: Anti–citrullinated protein antibody
text: performance of the test. Noteworthy are the findings of a recently published study that highly valuates anti-MCV test systems for diagnosing rheumatoid arthritis in anti-CCP-negative patients. However, data from all around the world vary substantially. Anti-CCP is also very useful in the early diagnosis of rheumatoid arthritis in high-risk groups, such as relatives of RA patients, although Silman and co-workers found that the concordance rate of developing RA was 15.4% among identical (monozygotic) twins and was 3.6% among fraternal (dizygotic) twins. Given that ACPA are more specific than rheumatoid factor, they are used to distinguish various causes of arthritis. Novel

title: Rheumatoid factor
text: may serve as one of several serological markers for autoimmunity. The sensitivity of RF for established rheumatoid arthritis is only 60-70% with a specificity of 78%. High levels of rheumatoid factor (in general, above 20 IU/mL, 1:40, or over the 95th percentile; there is some variation among labs) occur in rheumatoid arthritis (present in 80%) and Sjögren's syndrome (present in 70%). The higher the level of RF the greater the probability of destructive articular disease. It is also found in Epstein–Barr virus or Parvovirus infection and in 5 to 10% of healthy persons, especially the elderly. There is an association

title: Sjögren syndrome
text: tests can be done to determine if a patient has high levels of antibodies that are indicative of the condition, such as antinuclear antibody (ANA) and rheumatoid factor (because SS frequently occurs secondary to rheumatoid arthritis), which are associated with autoimmune diseases. Typical SS ANA patterns are SSA/Ro and SSB/La, of which Anti-SSB/La is far more specific; Anti-SSA/Ro is associated with numerous other autoimmune conditions, but are often present in SS. However, Anti-SSA and Anti-SSB tests are frequently not positive in SS. The rose bengal test uses a stain that measures state and function of the lacrimal glands. This test

title: Biomarker (medicine)
text: laboratory parameter that the doctor can use to help make decisions in making a diagnosis and selecting a course of treatment. For example, the detection of certain autoantibodies in patient blood is a reliable biomarker for autoimmune disease, and the detection of rheumatoid factors has been an important diagnostic marker for rheumatoid arthritis (RA) for over 50 years. For the diagnosis of this autoimmune disease the antibodies against the bodies own citrullinated proteins are of particular value. These ACPAs, (ACPA stands for "A"nti-"c"itrullinated "p"rotein/peptide "a"ntibody) can be detected in the blood before the first symptoms of RA appear. They are

title: Rheumatoid arthritis
text: abnormally glycosylated antibodies, which are believed to promote joint inflammation. Once the generalized abnormal immune response has become established – which may take several years before any symptoms occur – plasma cells derived from B lymphocytes produce rheumatoid factors and ACPA of the IgG and IgM classes in large quantities. These activate macrophages through Fc receptor and complement binding, which is part of the intense inflammation in RA. Binding of an autoreactive antibody to the Fc receptors is mediated through the antibody's N-glycans, which are altered to promote inflammation in people with RA. This contributes to local inflammation in a

title: Biomarker (medicine)
text: thus highly valuable biomarkers for the early diagnosis of this autoimmune disease. In addition, they indicate if the disease threatens to be severe with serious damage to the bones and joints, which is an important tool for the doctor when providing a diagnosis and developing a treatment plan. There are also more and more indications that ACPAs can be very useful in monitoring the success of treatment for RA. This would make possible the accurate use of modern treatments with biologicals. Physicians hope to soon be able to individually tailor rheumatoid arthritis treatments for each patient. According to Häupl T.

title: Mutated citrullinated vimentin
text: greater than that of rheumatoid factor. Recently a serological point-of-care test (POCT) for the early detection of RA has been developed. This assay combines the detection of rheumatoid factor and anti-MCV for diagnosis of rheumatoid arthritis and shows a sensitivity of 72% and specificity of 99.7%. Anti-MCV are used as efficient biomarkers for estimating progress of rheumatoid arthritis. Main advantage of testing for anti-MCV is the early appearance of the anti-MCV antibodies, what allows for detection of early RA and submits adequate therapy just after the disease’s onset. Moreover, anti-MCV titres show strong correlation to disease activity, disease severity and

title: Reactive arthritis
text: clinical picture is dominated by arthritis in one or more joints, resulting in pain, swelling, redness, and heat sensation in the affected areas. The urethra, cervix and the throat may be swabbed in an attempt to culture the causative organisms. Cultures may also be carried out on urine and stool samples or on fluid obtained by arthrocentesis. Tests for C-reactive protein and erythrocyte sedimentation rate are non-specific tests that can be done to corroborate the diagnosis of the syndrome. A blood test for the genetic marker HLA-B27 may also be performed. About 75 percent of all the patients with reactive

title: Arthritis
text: infantile patient refuses to use the affected limb. Elements of the history of the disorder guide diagnosis. Important features are speed and time of onset, pattern of joint involvement, symmetry of symptoms, early morning stiffness, tenderness, gelling or locking with inactivity, aggravating and relieving factors, and other systemic symptoms. Physical examination may confirm the diagnosis, or may indicate systemic disease. Radiographs are often used to follow progression or help assess severity. Blood tests and X-rays of the affected joints often are performed to make the diagnosis. Screening blood tests are indicated if certain arthritides are suspected. These might include: rheumatoid

title: Anti–citrullinated protein antibody
text: thereby generating an immune response. ACPAs have proved to be powerful biomarkers that allow the diagnosis of rheumatoid arthritis (RA) to be made at a very early stage. In July 2010, the "2010 ACR/EULAR Rheumatoid Arthritis Classification Criteria" were introduced. These new classification criteria include ACPA testing, and overruled the "old" ACR criteria of 1987 and are adapted for early RA diagnosis. The presence of autoantibodies against citrullinated proteins in rheumatoid arthritis patients was first described in the mid-1970s when the biochemical basis of antibody reactivity against keratin and filaggrin was investigated. Subsequent studies demonstrated that autoantibodies from RA patients

title: Felty's syndrome
text: diagnose due to its complexity given a combination of disorders. It is commonly overlooked or misdiagnosed as other conditions (e.g., leukemia, systemic lupus erythrematosus) because of the rarity and lack of good understanding about it. An acronym can be used to make recognizing this disease somewhat easier: S: Splenomegaly A: Anemia N: Neutropenia T: Thrombocytopenia A: Arthritis (rheumatoid) A complete blood count (CBC) can be done to diagnose anemia (normochromic, normocytic), thrombocytopenia, and neutropenia. Abnormal liver function tests are commonly used to help in diagnosis as the spleen and liver are strongly affected by one another. If rheumatoid arthritis is

title: Anti-nuclear antibody
text: the test. For example, IgM-rheumatoid factor (IgM-RF) have been shown to cross-react with ANA giving falsely positive immunofluorescence. Positive ANA as well as anti-DNA antibodies have been reported in patients with autoimmune thyroid disease. ANA can have a positive test result in up to 45% of people with autoimmune thyroid conditions or rheumatoid arthritis and up to 15% of people with HIV or hepatitis C. As per Lupus Foundation of America, "about 5% of the general population will have a positive ANA. However, at least 95% of the people who have a positive ANA do not have lupus! A positive

title: Relapsing polychondritis
text: proximal interphalangeal joints and knees. After which is followed by the ankles, wrists, metatarsophalangeal joints and the elbows. Any involvement of the axial skeleton is considered to be very rare. Tests for rheumatoid factor are negative in affected persons with RP, unless there is a co-morbidity with RA. Less often it has been reported that persons may experience arthralgia, monoarthritis, or chronic polyarthritis that mimics rheumatoid arthritis, leading to a difficult diagnosis for this disease. The appearance of erosions and destruction, however, is exceedingly rare and this may point instead to rheumatoid arthritis as a cause. Diseases and inflammation of

title: Septic arthritis
text: on physical exam and prompt arthrocentesis which yields synovial fluid from within the affected joint. This fluid should be collected before the administration of antibiotics and should be sent for gram stain, culture, leukocyte count with differential, and crystal studies. This can include NAAT testing for N. gonorrhoeae if suspected in a sexually active patient. Other studies such as blood cultures, white blood cell count with differential, ESR, and CRP should also be included. However, white cell count, ESR, and CRP are nonspecific and could be elevated due to infection elsewhere in the body. Serologic studies should be done if