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Thursday, December 5, 2013
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."
Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University