Rheumatoid arthritis

1. RHEUMATOID PROFILE
PRESENTED BY
SHARON MICHAEL

2. CONTENT
• INTRODUCTION
• RHEUMATOID ARTHRITIS
• RISK FACTORS
• SIGNS AND SYMPTOMS
• LAB DIAGNOSIS
• PREVENTION
• CONCLUSION
• REFERENCE

3. INTRODUCTION
• Rheumatoid profile blood test
can provide important
information about
rheumatologic conditions.
• This blood test is used to detect
rheumatoid arthritis.

4. RHEUMATOID ARTHRITIS
• Rheumatoid arthritis(RA) is a chronic inflammatory disorder, that
may affect many tissues and organs, also it is a systemic
inflammatory disease charecterised by symmetrical joint
involvement.
• Rheumatoid factor(RF) was the first autoantibody to be
discovered in people with rheumatoid arthritis.
• Autoantibodies develop in response to the body’s own tissue and
are characteristic of autoimmune disease, such as rheumatoid
arthritis.

5. RISK FACTORS
• Idiopathic
• Positive family history
• Inherited tissue type major histocompatibility
complex(MCH) antigen
• Smoking
• Obesity
• Bacterial & fungal infection
• Epstein – Bar virus(EBV)
• Herpes simplex virus infection
• Vitamin D deficiency

6. SIGNS AND SYMPTOMS
Fatigue
Joint pain
Joint tenderness
Joint swelling
Joint redness
Joint warmth
Joint stiffness
Limping
Joint deformity
poly arthritis
Loss of joint range of motion
Both side of the body affected

7. • Rheumatoid arthritis is charecterised by the infiltration of a
variety of inflammatory cells in to the joints.
• But RA affects your joints as well as other systems in your body,
include extra articular involvement,rheumatoid
nodules,vasculitis,eye inflammation,neurologic
dysfunction,cardiopulmonary disease,lympadinopathy,and
splenomegaly.

8. LAB DIAGNOSIS
• Diagnosing and managing rheumatoid arthritis involves clinical
evaluation by a rheumatologist, as well as several different
laboratory tests.
• The results of these tests may be used in two ways
• To confirm the presence of the rheumatoid arthritis
• To determine how active the disease is.

9. RHEUMATOID FACTOR[RF] TEST
• Rheumatoid factors[RFs] are poly reactive IgM antibodies produced by
a subset of B lymphocytes and bind to the fc portion of the IgG
molecule.
• These proteins can be found in circulating blood.
• A negative rheumatoid factor does not rule out rheumatoid arthritis, is
then called seronegative, most commonly, during the first year of
illness. Then converting to seropositive status over time
• A rheumatoid factor test is often used to help diagnose rheumatoid
arthritis and other autoimmune disorders.

10. PRINCIPLE OF RHEUMATOID FACTOR
TEST
• If the rheumatoid factor is present in the patient blood, it attaches
to IgG coating the latex particle, causing clumps.
• Specimen : serum
• The two type test are there qualitative and quantitative
• Qualitative test – This test is used to determine the presence of
rheumatoid factor antibodies in the blood.
• Quantitative test – This test is used to determine the level of
rheumatoid factor antibody in the blood.

11. QUALITATIVE TEST [SLIDE METHOD]
• Place one drop (40µl) of positive control, negative control and
patient serum sample to the respective circles on the slide by using
a disposable serum dropper or micro pipette.
• Add one drop of RF-latex reagent to the above each circle on the
slide and mix with disposable applicator stick.
• Rock the slide gently and after 2min immediately examine under
good light source for agglutination.Do not examine beyond
2minutes.

12. RESULTS
• Positive reaction: always seen in agglutination
• Negative reaction: absence of visible agglutination

13. QUANTITATIVE METHOD
• This test measures the amount of rheumatoid factor (RF)
antibody in the blood.
METHODS
• Automated quantitative methods for measuring rheumatoid
factor include
• Fluorescence immunoassay (FIA)
• Enzyme linked immunosorbent assay (ELISA)
• Radioimmunoassay (RIA)
• Normal range of RF is up to 20 IU/ml

14. ANTICYCLIC CITRULINATED PEPTIDE
(ANTI CCP)
• Anti ccp test is used to help diagnose rheumatoid arthritis.
• It is often done along with or after a rheumatoid factor test.
• If you have symptoms of rheumatoid arthritis,and your results
show,positive CCP antibodies and positive RF,it likely means that
you have rheumatoid arthritis.
• Positive CCP antibodies and negative RF,it may mean you are in
the early stages of rheumatoid arthritis or will develop it in the
future.
• Method:- ELISA and Enzyme immuno assay.
• Normal range : 0-20 IU/ml

15. ANA/ANA PROFILE
• ANA test identify antinuclear antibodies in your blood and helps to
diagnose autoimmune disorders such as systemic lupus
erythromatus (SLE),Rheumatoid arthrities, scleroderma, sjogenm's
syndrome,mixed connective tissue disease and addisons disease etc.
• The objective of ANA profile test determines all antinuclear
antibodies present in our body specific to autoimmune disorders,
such as Anti-Sm which is highly specific for SLE and Anti-RNP
which is highly specific for rheumatoid disease.

16. ESR
• An ESR test can help to measure inflammation in your body.
• It looks at how quickly RBC may sink to the bottom of the ESR
tube.
• With a high rate of settlement indicate high inflammation
Normal range
Male: 0-15 mm/hr
Female :0-20 mm/hr
OTHER BLOOD TEST PERFORMED WHEN RA
IS SUSPECTED

17. CRP
• C-reactive protein is a measure of clinical information often used
in addition to an ESR.
• Both ESR & CRP are non RA specific measures of inflammation.
• Both test are used to test disease activity.
• Normal range : 0- 6 mg/dl
CBC
• The CBC tests help to know about side effect of treatment and
any secondary consequence of RA,such as anemia.
• CBC test gives information about all blood cells.
• Renal function test and liver enzyme test are also the further
investigations.

18. PREVENTION
• Drugs : disease modifying antirhrumatic
drugs (DMARDs) are used for
symptomatic relief.
• Don’t smoke
• Eat mediterean diet [high in
vegetables,fruit,olive oil and whole
grains].
• Exercise
• Avoid high salt in your diet.
• Add more fish and omega-3 to your diet.
• Avoid sugar and soft drinks. 18

19. CONCLUSION
• Mostly rheumatoid factor is affected in female more than in male
ratio is 3:1 but people of any age can be affected.
• Peak age 45-65 but onset early from 20-45 years. About 75%of
these are women.

20. REFERANCE
• National Institute of Arthritis and Musculoskeletal and Skin Diseases. August
2014. Archived from the original on June 30, 2015. Retrieved July 2, 2015.
• Majithia V, Geraci SA (November 2007). "Rheumatoid arthritis: diagnosis and
management". The American Journal of Medicine.
• Balbir-Gurman A, Yigla M, Nahir AM, Braun-Moscovici Y (June 2006).
"Rheumatoid pleural effusion". Seminars in Arthritis and Rheumatism. 35 (6):
368–378.
• Rennie KL, Hughes J, Lang R, Jebb SA (April 2003). "Nutritional
management of rheumatoid arthritis: a review of the evidence". Journal of
Human Nutrition and Dietetics