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Arthritis and Rheumatism

Rheumatoid arthritis and negative RF



Can someone have rheumatoid arthritis (RA) and still be rheumatoid factor (RF) negative? I read that there is a serious form of RA that is also sero negative. What are its` symptoms and can it be diagnosed with the CCP test?


Yes, a diagnosis of RA can be established in the setting of a normal Rheumatoid Factor (RF) laboratory. An RF is present in about 70%-80% of people with RA. A Cyclic Citrullinated Peptide (CCP) antibody is an alternative laboratory that can assist in the diagnosis of RA, also being present in about 70%-80% of people with RA. RF and CCP positivity may overlap but are not necessarily identical in distribution. In other words, it is possible to have an elevated RF and a normal CCP or vice versa. Finally, while the presence of an RF and/or a CCP seem to imply a higher risk of destructive joint disease in RA, one can have aggressive disease even if they are "seronegative."

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Response by:

Raymond  Hong, MD, MBA, FACR Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University