Rheumatoid arthritis laboratory tests: Difference between revisions
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==Overview== | ==Overview== | ||
Laboratory tests used to diagnose [[rheumatoid arthritis]] include [[complete blood count]] with differentials, [[erythrocyte sedimentation rate]], [[CRP]], renal function test, [[LFT]]<nowiki/>s, and [[antibodies]] such as [[rheumatoid factor]], anti-[[CCP]], and anti MCV. | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
Following tests are used to make the diagnosis of rheumatoid arthritis:<ref name="pmid769705">{{cite journal |vauthors=Bayliss CE, Dawkins RL, Cullity G, Davis RE, Houliston JB |title=Laboratory diagnosis of rheumatoid arthritis. Prospective study of 85 patients |journal=Ann. Rheum. Dis. |volume=34 |issue=5 |pages=395–402 |date=October 1975 |pmid=769705 |pmc=1006439 |doi= |url=}}</ref><ref name="pmid22150658">{{cite journal |vauthors=Wasserman AM |title=Diagnosis and management of rheumatoid arthritis |journal=Am Fam Physician |volume=84 |issue=11 |pages=1245–52 |date=December 2011 |pmid=22150658 |doi= |url=}}</ref> | Following tests are used to make the diagnosis of [[rheumatoid arthritis]]:<ref name="pmid769705">{{cite journal |vauthors=Bayliss CE, Dawkins RL, Cullity G, Davis RE, Houliston JB |title=Laboratory diagnosis of rheumatoid arthritis. Prospective study of 85 patients |journal=Ann. Rheum. Dis. |volume=34 |issue=5 |pages=395–402 |date=October 1975 |pmid=769705 |pmc=1006439 |doi= |url=}}</ref><ref name="pmid22150658">{{cite journal |vauthors=Wasserman AM |title=Diagnosis and management of rheumatoid arthritis |journal=Am Fam Physician |volume=84 |issue=11 |pages=1245–52 |date=December 2011 |pmid=22150658 |doi= |url=}}</ref> | ||
*Complete blood count with differentials | *[[Complete blood count]] with differentials | ||
**Low [[haemoglobin]] | |||
**[[Neutropenia]] | |||
*Platelet count | |||
**[[Thrombocytosis]] | |||
*Acute phase reactant are used to measure disease progression:<ref name="pmid8508266">{{cite journal |vauthors=van Leeuwen MA, van Rijswijk MH, van der Heijde DM, Te Meerman GJ, van Riel PL, Houtman PM, van De Putte LB, Limburg PC |title=The acute-phase response in relation to radiographic progression in early rheumatoid arthritis: a prospective study during the first three years of the disease |journal=Br. J. Rheumatol. |volume=32 Suppl 3 |issue= |pages=9–13 |date=June 1993 |pmid=8508266 |doi= |url=}}</ref> | *Acute phase reactant are used to measure disease progression:<ref name="pmid8508266">{{cite journal |vauthors=van Leeuwen MA, van Rijswijk MH, van der Heijde DM, Te Meerman GJ, van Riel PL, Houtman PM, van De Putte LB, Limburg PC |title=The acute-phase response in relation to radiographic progression in early rheumatoid arthritis: a prospective study during the first three years of the disease |journal=Br. J. Rheumatol. |volume=32 Suppl 3 |issue= |pages=9–13 |date=June 1993 |pmid=8508266 |doi= |url=}}</ref> | ||
**Erythrocyte sedimentation rate | **[[Erythrocyte sedimentation rate]] | ||
**C-reactive protein: CRP gives an idea about the radiological progression and mean CRP correlates with articular index | **[[C-reactive protein]]: [[CRP]] gives an idea about the radiological progression and mean [[CRP]] correlates with articular index | ||
*Renal function test | *[[Renal function tests|Renal function test]] - usually dearranged in complication of RA | ||
*Liver function test | *[[Liver function tests|Liver function test]] - abnormal in complication of RA | ||
*Antibodies | *[[Antibodies]] | ||
**[[Rheumatoid factor]] | **[[Rheumatoid factor]]: | ||
*** It has mean specificity of 79%, with sensitivity of about 60%<ref name="pmid24024009">{{cite journal |vauthors=Heidari B |title=Rheumatoid Arthritis: Early diagnosis and treatment outcomes |journal=Caspian J Intern Med |volume=2 |issue=1 |pages=161–70 |date=2011 |pmid=24024009 |pmc=3766928 |doi= |url=}}</ref><ref name="pmid15103252">{{cite journal |vauthors=Dörner T, Egerer K, Feist E, Burmester GR |title=Rheumatoid factor revisited |journal=Curr Opin Rheumatol |volume=16 |issue=3 |pages=246–53 |date=May 2004 |pmid=15103252 |doi= |url=}}</ref> | *** It has mean specificity of 79%, with sensitivity of about 60%<ref name="pmid24024009">{{cite journal |vauthors=Heidari B |title=Rheumatoid Arthritis: Early diagnosis and treatment outcomes |journal=Caspian J Intern Med |volume=2 |issue=1 |pages=161–70 |date=2011 |pmid=24024009 |pmc=3766928 |doi= |url=}}</ref><ref name="pmid15103252">{{cite journal |vauthors=Dörner T, Egerer K, Feist E, Burmester GR |title=Rheumatoid factor revisited |journal=Curr Opin Rheumatol |volume=16 |issue=3 |pages=246–53 |date=May 2004 |pmid=15103252 |doi= |url=}}</ref> | ||
**Antibodies to cyclic citrullinated peptides (anti-CCP antibodies):<ref name="pmid12607587">{{cite journal |vauthors=van Venrooij WJ, Hazes JM, Visser H |title=Anticitrullinated protein/peptide antibody and its role in the diagnosis and prognosis of early rheumatoid arthritis |journal=Neth J Med |volume=60 |issue=10 |pages=383–8 |date=November 2002 |pmid=12607587 |doi= |url=}}</ref><ref name="pmid10643712">{{cite journal |vauthors=Schellekens GA, Visser H, de Jong BA, van den Hoogen FH, Hazes JM, Breedveld FC, van Venrooij WJ |title=The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide |journal=Arthritis Rheum. |volume=43 |issue=1 |pages=155–63 |date=January 2000 |pmid=10643712 |doi=10.1002/1529-0131(200001)43:1<155::AID-ANR20>3.0.CO;2-3 |url=}}</ref> | **Antibodies to cyclic citrullinated peptides (anti-[[CCP]] [[antibodies]]):<ref name="pmid12607587">{{cite journal |vauthors=van Venrooij WJ, Hazes JM, Visser H |title=Anticitrullinated protein/peptide antibody and its role in the diagnosis and prognosis of early rheumatoid arthritis |journal=Neth J Med |volume=60 |issue=10 |pages=383–8 |date=November 2002 |pmid=12607587 |doi= |url=}}</ref><ref name="pmid10643712">{{cite journal |vauthors=Schellekens GA, Visser H, de Jong BA, van den Hoogen FH, Hazes JM, Breedveld FC, van Venrooij WJ |title=The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide |journal=Arthritis Rheum. |volume=43 |issue=1 |pages=155–63 |date=January 2000 |pmid=10643712 |doi=10.1002/1529-0131(200001)43:1<155::AID-ANR20>3.0.CO;2-3 |url=}}</ref> | ||
***It has specificity of about 81-100%, with sensitivity of 39–94% | ***It has specificity of about 81-100%, with sensitivity of 39–94% | ||
**Antibodies to citrullinated vimentin and mutated citrullinated vimentin (MCV): | **Antibodies to citrullinated vimentin and mutated citrullinated vimentin (MCV): | ||
***It has specificity of about 90.3–98%, with sensitivity of 69.5–82% | ***It has specificity of about 90.3–98%, with sensitivity of 69.5–82% | ||
==References== | ==References== |
Latest revision as of 17:00, 23 April 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]
Overview
Laboratory tests used to diagnose rheumatoid arthritis include complete blood count with differentials, erythrocyte sedimentation rate, CRP, renal function test, LFTs, and antibodies such as rheumatoid factor, anti-CCP, and anti MCV.
Laboratory Findings
Following tests are used to make the diagnosis of rheumatoid arthritis:[1][2]
- Complete blood count with differentials
- Platelet count
- Acute phase reactant are used to measure disease progression:[3]
- Erythrocyte sedimentation rate
- C-reactive protein: CRP gives an idea about the radiological progression and mean CRP correlates with articular index
- Renal function test - usually dearranged in complication of RA
- Liver function test - abnormal in complication of RA
- Antibodies
- Rheumatoid factor:
- Antibodies to cyclic citrullinated peptides (anti-CCP antibodies):[6][7]
- It has specificity of about 81-100%, with sensitivity of 39–94%
- Antibodies to citrullinated vimentin and mutated citrullinated vimentin (MCV):
- It has specificity of about 90.3–98%, with sensitivity of 69.5–82%
References
- ↑ Bayliss CE, Dawkins RL, Cullity G, Davis RE, Houliston JB (October 1975). "Laboratory diagnosis of rheumatoid arthritis. Prospective study of 85 patients". Ann. Rheum. Dis. 34 (5): 395–402. PMC 1006439. PMID 769705.
- ↑ Wasserman AM (December 2011). "Diagnosis and management of rheumatoid arthritis". Am Fam Physician. 84 (11): 1245–52. PMID 22150658.
- ↑ van Leeuwen MA, van Rijswijk MH, van der Heijde DM, Te Meerman GJ, van Riel PL, Houtman PM, van De Putte LB, Limburg PC (June 1993). "The acute-phase response in relation to radiographic progression in early rheumatoid arthritis: a prospective study during the first three years of the disease". Br. J. Rheumatol. 32 Suppl 3: 9–13. PMID 8508266.
- ↑ Heidari B (2011). "Rheumatoid Arthritis: Early diagnosis and treatment outcomes". Caspian J Intern Med. 2 (1): 161–70. PMC 3766928. PMID 24024009.
- ↑ Dörner T, Egerer K, Feist E, Burmester GR (May 2004). "Rheumatoid factor revisited". Curr Opin Rheumatol. 16 (3): 246–53. PMID 15103252.
- ↑ van Venrooij WJ, Hazes JM, Visser H (November 2002). "Anticitrullinated protein/peptide antibody and its role in the diagnosis and prognosis of early rheumatoid arthritis". Neth J Med. 60 (10): 383–8. PMID 12607587.
- ↑ Schellekens GA, Visser H, de Jong BA, van den Hoogen FH, Hazes JM, Breedveld FC, van Venrooij WJ (January 2000). "The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide". Arthritis Rheum. 43 (1): 155–63. doi:10.1002/1529-0131(200001)43:1<155::AID-ANR20>3.0.CO;2-3. PMID 10643712.