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Medicine

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Rheumatology

Question
17 out of 30
 

False positive rheumatoid factor can be associated with all except: (AI 2009)



A Inflammatory bowel disease

B HBsAg

C VDRL

D Coombs test

Ans. A Inflammatory bowel disease

Laboratory findings

RA factor (IgM) is positive in 75% patients of RA though it is found in 5% of healthy persons.

Other conditions in which RA factor is positive are – (AIPG 2009)

Rheumatoid factor: (It is of diagnostic & prognostic significance but it is not a test for screening)

i. It is an autoantibody It is an antibody against the Fc portion of IgG.

ii. RF and IgG join to form immune complexes which contribute to the disease process.

iii. It can play a role in both diagnosis and disease prognosis.

iv. It is part of the usual disease criteria of rheumatoid arthritis.

v. Patients on treatment, a decline in the level of rheumatoid factor is associated with reduced clinical disease activity.

Other conditions where RA factor may be positive:

a. 5% of the normal population, b. SLE, c. Sjogren’s syndrome, d. Interstitial pulmonary fibrosis, e. Hepatitis B, f. Leprosy, g. Bacterial endocarditis, h. After vaccination/transfusion in normal individuals, i. Chronic liver disease, j. Sarcoidosis, k. Infections mononucleosis, l. Tuberculosis, m. Syphilis, n. Visceral leishmaniasis, o. Malaria

Extra Edge:

1. RA factor is a diagnostic criteria and also a prognostic criteria but it is not used as a screening criteria.

2. RA factor is positive in hepatitis B (HBsAg) syphilis (VDRL), SLE (Positive Coombs’ test)

(2) Anti CCP antibody are seen. They are the most specific for diagnosing RA.

(3) Anemia – Normocytic normochromic anemia and is due to ineffective erythropoiesis

(4) ESR – It is increased in all patients with active RA.

(5) C – reactive protein and ceruloplasmin are increased

(6) Synovial fluid analysis –

a. Turbid b. Decreased viscosity Q, c. Increase protein content

d. Decrease glucose concentration e. WBC count is 5000 – 50000 per ml

Rheumatology Flashcard List

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