Recently, 47-year-old Ms. Wang got the physical examination report and found that the "rheumatoid factor" index in the blood test column was positive, which made her worried and suspected that she might have a difficult disease - rheumatoid arthritis.
In fact, many medical examiners will encounter this situation when they see a positive rheumatoid factor. However, does a positive rheumatoid factor mean that you have rheumatoid arthritis?
A positive rheumatoid factor does not equate to rheumatoid arthritis
"Rheumatoid factor (RF) is a denatured immunoglobulin, belonging to autoantibodies, ubiquitous in the human body, although rheumatoid factor is one of the important serological criteria for the diagnosis of rheumatoid arthritis, but it is not the only standard and exclusive mark, therefore, a positive rheumatoid factor does not necessarily mean that you will suffer from rheumatoid arthritis", Xi'an Fifth Hospital (Shaanxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine) Liu Jinlian, deputy chief physician of the seventh ward of the Department of Rheumatology and Immunology, said that after the physical examination, many people panicked when they saw that the rheumatoid factor on the report was positive, but in fact, it was not necessary, "As an autoantibody, rheumatoid factor participates in a series of biological reactions, such as regulating the immune response in the body, activating the complement system in the body, accelerating the clearance of microbial infections and removing immune complexes to protect the body from damage to circulatory complexes." Usually, the normal range of rheumatoid factor is 0-20.0 IU/ml, and any other than the normal range may indicate that you have some rheumatic immune disease. ”
Liu Jinlian pointed out that although rheumatoid factor and rheumatoid arthritis have a certain relationship, and 60%-80% of patients with rheumatoid arthritis are also positive for rheumatoid factor, rheumatoid factor is not an antibody unique to rheumatoid arthritis, but also appears in other autoimmune diseases such as Sjögren's syndrome, systemic lupus erythematosus, systemic sclerosis, myositis/dermatomyositis, etc. Rheumatoid factor positivity can also be detected in certain non-rheumatic diseases, such as tumors, and may even occur in 5% of healthy people. Therefore, when the test is positive for rheumatoid factor, there is no need to be nervous, let alone blindly use drugs, you should go to the rheumatology and immunology department for formal screening, and the doctor will help find the cause of the elevated rheumatoid factor and give reasonable intervention advice.
A comprehensive evaluation is required to determine whether you have rheumatoid arthritis
It is precisely because there are multiple possibilities of being positive for rheumatoid factor that the diagnosis of rheumatoid arthritis must be determined by comprehensive evaluation based on clinical manifestations, laboratory tests, and imaging examination results.
Liu Jinlian said that when the physical examination is positive for rheumatoid factor, it is also necessary to see whether the patient has the following conditions, such as whether there is a family history of rheumatism and immune diseases, whether there are morning stiffness symptoms longer than 6 weeks, whether there is joint swelling and pain, and whether there are subcutaneous nodules, imaging changes, ultrasound synovitis changes, etc., "If there are no clinical manifestations and the antibody titer value is only slightly increased, you can first conduct a period of observation, through every 3- Follow-up examination every 6 months to observe the trend of rheumatoid factor, and if it continues to increase, further evaluation will be carried out."
In fact, a positive test for rheumatoid factor requires further testing, and a negative test for rheumatoid factor should not be taken lightly. Liu Jinlian reminded that when there are symptoms of joint swelling and pain in the body, or the joints are inflexible or even deformed, they should also be vigilant against rheumatoid arthritis. Therefore, regardless of whether the rheumatoid factor is positive or not, when the body has joint problems, especially deformation, pain, and swelling, you should go to the hospital for examination and diagnosis as soon as possible to avoid delaying the condition.
Huashang Daily reporter Wu Jie
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