A comprehensive assay used to evaluate the activity and monitor treatment of rheumatoid arthritis.
Synonyms Russian
Blood tests for rheumatoid arthritis (RA).
English synonyms
Rheumatoid arthritis (RA) blood panel;
Rheumatoid arthritis laboratory tests;
Rheumatoid arthritis work up.
What biomaterial can be used for research?
Venous blood.
How to properly prepare for research?
- Eliminate alcohol from your diet for 24 hours before the test.
- Children under 1 year of age should not eat for 30-40 minutes before the test.
- Children aged 1 to 5 years should not eat for 2-3 hours before the test.
- Do not eat for 12 hours before the test; you can drink clean still water.
- Completely avoid (in consultation with your doctor) taking medications for 24 hours before the test.
- Avoid physical and emotional stress for 30 minutes before the test.
- Do not smoke for 30 minutes before the test.
General information about the study
Rheumatoid arthritis is a chronic autoimmune disease, the course of which varies from mild oligoarthritis to rapid destruction of many joints and disability. To assess the activity of this disease, its prognosis, make decisions on prescribing basic drugs and monitor treatment, several clinical and laboratory markers are used. Particularly convenient for the doctor and the patient is a comprehensive blood test, which includes all the necessary indicators.
A comprehensive blood test for rheumatoid arthritis consists of 4 parts: inflammatory markers, hematological, biochemical and immunological parameters.
Markers of inflammation are erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and fibrinogen. High levels of ESR, CRP, or fibrinogen reflect disease activity. In addition, CRP levels have been shown to be associated with progressive joint destruction as measured by radiological studies. Fibrinogen is not only an acute phase protein of inflammation, but also a blood clotting factor, high levels of which are associated with the risk of thrombosis and cardiovascular diseases. A similar association has been shown for CRP. Indeed, the risk of cardiovascular disease and stroke is increased in patients with rheumatoid arthritis.
Hematological indicators are a complete blood count (CBC) and leukocyte count. With the help of OAC, it is possible to identify and assess the severity of anemia in rheumatoid arthritis. With this disease, anemia of chronic diseases is most often observed, the severity of which reflects the activity of the disease. With a good response to therapy, blood counts return to normal. Another common form of anemia is iron deficiency anemia, caused by hidden bleeding of the gastrointestinal tract when using NSAIDs. To differentiate the two types of anemia in rheumatoid arthritis, iron level tests may be necessary. Also, with the help of CBC, it is possible to detect thrombocytosis, which reflects disease activity, or thrombocytopenia, which can occur as a complication when taking medications or is a symptom of hypersplenism in Felty's syndrome. In rheumatoid arthritis, as a rule, moderate leukocytosis is observed. Leukopenia can occur as a complication when taking medications or, by analogy with thrombocytopenia, is a symptom of Felty's syndrome.
Biochemical parameters that are studied in rheumatoid arthritis include liver enzymes (ALT, AST) and total serum protein. Liver enzymes are examined to assess hepatotoxicity likely when prescribing basic drugs and timely adjustment of their dose. Elevated liver enzyme levels occur in 10-35% of patients receiving a combination of methotrexate and leflunomide. Total serum protein is an integral indicator of the body's protein metabolism, which is often impaired in chronic diseases, including rheumatoid arthritis. It should be noted that the level of total protein can be normal even in severe cases of the disease.
Immunological indicators - rheumatoid factor (RF) and antibodies to cyclic citrulline-containing peptide (ACCP) - are used not only for diagnosis, but also for assessing the activity and prognosis of rheumatoid arthritis. RF are immunoglobulins of the IgM class to the Fc fragment of IgG immunoglobulins. RF is detected in 60-80% of patients with rheumatoid arthritis, more often at the stage of a full-blown clinical picture. The sensitivity of this marker in the early stages of rheumatoid arthritis is about 40%. Thus, a negative RF test result does not completely exclude rheumatoid arthritis. RF levels vary to some extent with changes in disease activity, but may remain high even when clinical remission of the disease is achieved. The presence of RF is associated with progressive joint destruction according to X-ray examination, regardless of disease activity. RF is not a specific marker for rheumatoid arthritis and can be detected in many other autoimmune diseases, including systemic lupus erythematosus, ankylosing spondylitis, juvenile rheumatoid arthritis, sarcoidosis, and is also detected in 5-7% of healthy people. A more specific marker of rheumatoid arthritis are antibodies to cyclic citrulline-containing peptide (ACCP), IgG. ACCP is a heterogeneous group of autoantibodies that interact with the amino acid citrulline of various proteins (possibly fibrin, vimentin, type I and II collagen, histones and others), formed as a result of inflammatory changes in the joint. The specificity of this marker reaches 99%. Also, ACCPs are more often observed than RFs (60% compared to 40%) in the early stages of rheumatoid arthritis. It is believed that ACCP concentration may reflect disease activity. Detection of ACCP, like RF, is associated with joint destruction and is an unfavorable prognostic factor.
In some cases, additional tests may be needed, such as a fecal occult blood test in a patient taking NSAIDs or an assessment of kidney function in a patient taking methotrexate. It should be noted that laboratory examination is important, but not the only examination for rheumatoid arthritis. The results of a complex analysis must be assessed taking into account additional anamnestic, clinical and instrumental data.
What is the research used for?
- To assess the activity and monitor treatment of rheumatoid arthritis.
When is the study scheduled?
- If there are symptoms of joint damage: pain and limited mobility (stiffness) in the joints, swelling and redness of the skin in the joint area, especially with symmetrical damage to the small joints of the hands and feet;
- during a follow-up examination of a patient with rheumatoid arthritis.
What do the results mean?
Reference values
For each indicator included in the complex:
- [02-005] Clinical blood test (with leukocyte formula)
- [02-007] Erythrocyte sedimentation rate (ESR)
- [06-182] C-reactive protein, quantitative (method with normal sensitivity)
- [13-020] Rheumatoid factor
- [13-026] Anti-citrullinated vimentin (anti-MCV)
Symptoms of arthrosis
Like all degenerative-dystrophic changes in the musculoskeletal system, the cause of osteoarthritis is considered to be a violation of metabolic processes in the body. The most commonly diagnosed forms of the disease are osteoarthritis of the hip joint and arthrosis of the knee joint; arthrosis of the foot and arthrosis of the shoulder joint are less commonly diagnosed.
The very first symptom of arthrosis that brings a patient to see a doctor is the occurrence of pain in the damaged joint. At the beginning of the disease, the pain is not severe; it occurs with increased physical activity and goes away after rest, when the joint relaxes.
In addition, symptoms of the disease include the following:
- stiffness in the joints that occurs in the morning;
- joint pain that occurs after physical activity;
- decreased range of motion in the joint that is being destroyed;
- crunching in the joint (many people do not pay attention to this symptom, but it should definitely alert you);
- swelling of the joint, its instability.
2. Causes of arthritis (osteoarthritis)
There are several factors that increase your chance of developing arthritis:
- Heredity
. Some people have an inherited defect in one of the genes responsible for the formation of cartilage. This can cause rapid wear and tear on the joints. Those who were born with spinal curvature or scoliosis are prone to developing spinal osteoarthritis. - Obesity
. Obesity increases the risk of developing arthritis in the knee, hip and spine due to the excess stress of body weight on the joints. - Injuries
. Injuries can also affect the development of the disease. For example, athletes who have had a knee injury often develop knee arthritis. People who have had serious back injuries may be predisposed to developing osteoarthritis of the spine. A bone fracture can cause arthritis in the joint near the fracture site. - Excessive load on the joint
. Increased stress on a joint increases the risk of arthritis. For example, people whose jobs require constant bending of the knee are more likely to suffer from osteoarthritis of the knee. - Other diseases
. People with rheumatoid arthritis, the second most common form of the disease, are also prone to developing osteoarthritis. In addition, certain conditions, such as too much iron in the body or excess growth hormones, contribute to the development of osteoarthritis.
Visit our Rheumatology page
1.What is osteoarthritis and its symptoms?
Did you know that there are more than 100 types of arthritis? Common symptoms of this disease are pain, stiffness and impaired joint mobility. The most common type of arthritis is degenerative arthritis
, or
osteoarthritis
, which we will talk about in this article. Less common are rheumatoid arthritis and gout. Accurately diagnosing the type of arthritis is very important to selecting the right treatment.
What is osteoarthritis?
In general, the term “arthritis”
indicate
inflammation of the joints
. Osteoarthritis is its most common form. The disease is associated with damage to joint cartilage and can occur in any joint in the body. The joints that bear the heaviest weight loads are most often affected - the joints of the hips, knees and spine. The joints of the fingers, especially the thumb, and neck are often affected.
cartilage
- This is an elastic material that is found at the ends of the joints of the bone. The main function of cartilage is to reduce friction in the joints, that is, to serve as a kind of shock absorber. This opportunity is provided by the ability of healthy cartilage to change shape under compression and pressure (cartilage can become flat and press against each other).
Osteoarthritis leads to joint stiffness and loss of elasticity
. Over time, cartilage can wear out in some areas, become damaged, and as a result, the shock-absorbing ability of the cartilage is significantly reduced. As a result, tendons and ligaments are stretched and bones rub against each other, causing pain.
Osteoarthritis is a fairly common problem. Even people in their 20s and 30s can get sick. But in general, the likelihood of developing the disease increases with age. Most people over 60 have some degree of arthritis. Women suffer from arthritis more often than men.
Symptoms of arthritis (osteoarthritis).
Symptoms of arthritis most often develop gradually and may include:
- Pain, especially when moving;
- Pain after a long period of rest;
- Stiffness of joints after long periods of immobility;
- Enlargement (bonyness) in the finger joints, which may not be painful;
- Swelling of the joints.
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