Diagnosis and prognosis of early rheumatoid arthritis, with special emphasis on laboratory analysis

2006 ◽  
Vol 44 (2) ◽  
Author(s):  
Rudolf Mierau ◽  
Ekkehard Genth
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Presentation ◽  
Morning Stiffness ◽  
Specific Information ◽  
Rheumatoid Factors ◽  
Radiological Progression ◽  
Clinical Criteria ◽  
Diagnosis And Prognosis ◽  
Hands And Feet ◽  
Citrullinated Peptide

AbstractDiagnosis of rheumatoid arthritis (RA) is mainly based on clinical criteria of symmetric polyarthritis of the hands and feet, with morning stiffness lasting usually more than 1h. Autoantibodies typical for RA, i.e., rheumatoid factors and anti-cyclic citrullinated peptide, and measurements of inflammation add more specific information, especially for early diagnosis, where clinical presentation may be oligosymptomatic involving only a few joints. These laboratory parameters are also relevant for prognosis of disease persistence, functional impairment and radiological progression.

scholarly journals Rheumatoid Factors: Clinical Applications

2013 ◽  
Vol 35 ◽  
pp. 727-734 ◽  
Author(s):  
Francesca Ingegnoli ◽  
Roberto Castelli ◽  
Roberta Gualtierotti
Keyword(s):  
Rheumatoid Arthritis ◽  
Healthy Subjects ◽  
Therapeutic Strategy ◽  
Clinical Applications ◽  
Rheumatoid Factors ◽  
Cyclic Citrullinated Peptide ◽  
Rheumatoid Factor Isotypes ◽  
Form Part ◽  
Citrullinated Peptide ◽  
Peptide Antibodies

Rheumatoid factors are antibodies directed against the Fc region of immunoglobulin G. First detected in patients with rheumatoid arthritis 70 years ago, they can also be found in patients with other autoimmune and nonautoimmune conditions, as well as in healthy subjects. Rheumatoid factors form part of the workup for the differential diagnosis of arthropathies. In clinical practice, it is recommended to measure anti-cyclic citrullinated peptide antibodies and rheumatoid factors together because anti-cyclic citrullinated peptide antibodies alone are only moderately sensitive, and the combination of the two markers improves diagnostic accuracy, especially in the case of early rheumatoid arthritis. Furthermore, different rheumatoid factor isotypes alone or in combination can be helpful when managing rheumatoid arthritis patients, from the time of diagnosis until deciding on the choice of therapeutic strategy.

IgM, IgA, and IgG Rheumatoid Factors in Early Rheumatoid Arthritis Predictive of Radiological Progression?

1995 ◽  
Vol 24 (3) ◽  
pp. 146-153 ◽  
Author(s):  
M. A. Van Leeuwen ◽  
J. Westra ◽  
P.L.C.M. van Riel ◽  
P. C. Limburg ◽  
M. H. Van Rijswijk
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Rheumatoid Arthritis ◽  
Rheumatoid Factors ◽  
Radiological Progression

scholarly journals Plasma 25,OH Vitamin D Concentrations Are Not Associated with Rheumatoid Arthritis (RA)-related Autoantibodies in Individuals at Elevated Risk for RA

2009 ◽  
Vol 36 (5) ◽  
pp. 943-946 ◽  
Author(s):  
MARIE FESER ◽  
LEZLIE A. DERBER ◽  
KEVIN D. DEANE ◽  
DENNIS C. LEZOTTE ◽  
MICHAEL H. WEISMAN ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Vitamin D ◽  
Elevated Risk ◽  
Rheumatoid Factors ◽  
Increased Risk ◽  
Vitamin D Levels ◽  
25 Oh Vitamin D ◽  
Negative Controls ◽  
Citrullinated Peptide ◽  
Peptide Antibodies

Objective.To evaluate the association between rheumatoid arthritis (RA)-related autoantibodies and plasma 25,OH vitamin D in subjects at risk for RA.Methods.In 1210 subjects without RA, 76 were positive for anti-cyclic citrullinated peptide antibodies or for at least 2 rheumatoid factors (RF; by nephelometry: RF-IgM, RF-IgG, RF-IgA). 25,OH vitamin D was measured in these cases and 154 autoantibody-negative controls from this cohort.Results.25,OH vitamin D levels did not differ between cases and controls (adjusted OR 1.23, 95% CI 0.93–1.63).Conclusion.Vitamin D concentrations are not associated with RA-related autoimmunity in unaffected subjects at increased risk for RA.

scholarly journals Rheumatoid Arthritis and CLOVES Syndrome: A Tricky Diagnosis

Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 467
Author(s):  
Laura Damian ◽  
Andrei Lebovici ◽  
Cristina Pamfil ◽  
Cristina Belizna ◽  
Romana Vulturar
Keyword(s):  
Rheumatoid Arthritis ◽  
Venous Malformation ◽  
Pik3ca Mutation ◽  
Young Female ◽  
Leg Length ◽  
Clinical Criteria ◽  
Activating Mutations ◽  
Dysmorphic Features ◽  
History Of ◽  
Citrullinated Peptide

The PI3K/AKT/mTOR signaling pathway is significantly activated in rheumatoid arthritis. In addition, somatic activating mutations of the PI3K/AKT/mTOR pathway may result in PIK3CA-related overgrowth spectrum diseases, including CLOVES (Congenital Lipomatous Overgrowth, Vascular malformation, Epidermal nevi, Skeletal abnormalities/Scoliosis) syndrome. We describe the case of a young female patient, with anti-citrullinated peptide antibodies-positive rheumatoid arthritis, referred for persistent finger pain and stiffness. Examination revealed discrete macrodactyly involving two fingers, scoliosis, asymmetrical calves, venectasias, a shoulder nevus and triangular feet with a “sandal gap” between two toes. These mild dysmorphic features with early-onset and the history of surgeries for thoracic lipoma and venous malformation were strongly suggestive of CLOVES syndrome. Confirmatory mutation analysis was not performed, as blood or saliva testing is not contributive for tissue-specific localized effects in the PIK3CA-related overgrowth spectrum. Nevertheless, lack of detection of a PIK3CA mutation does not exclude the diagnosis in patients fulfilling clinical criteria. Due to the patient’s wish to plan a pregnancy, therapy consisted in sulfasalazine and hydroxychloroquine, along with orthotic correction of leg length discrepancy. Overgrowth syndromes and arthritis may share common pathways. Mild macrodactyly should be differentiated from dactylitis. Diagnosing patients with minimal dysmorphic features within the PI3K-related overgrowth spectrum may help design better care strategies, in the quest for personalized medicine.

scholarly journals Repair of Erosions in Patients with Rheumatoid Arthritis

2019 ◽  
Vol 46 (7) ◽  
pp. 670-675 ◽  
Author(s):  
Kristina Forslind ◽  
Kerstin Eberhardt ◽  
Björn Svensson
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatoid Factor ◽  
Early Rheumatoid Arthritis ◽  
Patient Age ◽  
Patient Âgé ◽  
Hands And Feet ◽  
Citrullinated Peptide ◽  
Anticyclic Citrullinated Peptide Antibodies ◽  
Over Time ◽  
Peptide Antibodies

Objective.The aim of this study was to examine the occurrence of repair in a cohort of conventionally treated patients with early rheumatoid arthritis over 8 years.Methods.There were 395 patients included in the BARFOT study having radiographs of hands and feet at inclusion, and at 1, 2, 5, and 8 years, which were chronologically scored for erosions by the Sharp/van der Heijde method. An erosion with repair was defined as an erosion that has become partially or totally filled, with or without sclerosis.Results.Erosions with repair were observed in 64 patients (16%) at 1 year, 113 (29%) at 2 years, 142 (36%) at 5 years, and 200 (51%) at 8 years. At the 1-year visit, 13% of the patients with at least 1 new erosion showed repair versus 3% of the patients with no new erosions (p = 0.001). At 2, 5, and 8 years the corresponding figures were 22% and 6%, 28% and 8%, and 39% and 11%, respectively (all p = 0.001). The sum of all repaired erosions correlated strongly with the sum of all erosions and with the sum of all erosion scores (ρ = 0.79 and 0.77). Presence of rheumatoid factor (RF) and anticyclic citrullinated peptide antibodies (anti-CCP) was significantly associated with both new erosions and repair.Conclusion.Repair was more common than previously described. The frequency of repair increased over time and was associated with the number of erosions. RF- and anti-CCP–positivity, patient age, and presence of erosions at baseline were independent predictors of repair.

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