How to reduce rheumatoid factor. Rheumatoid factor - about the norm, increase, causes, treatment

When visiting a traumatologist or rheumatologist, you can receive a referral for a blood test for rheumatoid factor (RF). In most cases, patients have no idea what it is and why such data is needed. But that's exactly what examination can reveal various diseases on early stages.

What is rheumatoid factor

Rheumatoid factor- This is a kind of group of autoantibodies. It was opened back in 1940. RF reacts to particles entering the human blood from affected joints. Their accumulation and the formation of so-called complexes can damage the walls of blood vessels.

There is another explanation for what rheumatoid factor is. This is a protein that, under the influence of viruses, bacteria or other internal factors is perceived by our immune system as a foreign particle. The body begins to actively produce antibodies, which are detected in laboratories. From all of the above, it becomes clear what it is – rheumatoid factor.

With age, the amount of antibodies in the blood may increase. U healthy people at the age of 65 years in 40% of cases there is positive reaction blood for rheumatoid factor.

Rheumatoid factor norms

Quite often, the results of blood tests for one person done in different clinics may turn out to be different. One reason is the use of different measurement quantities. Rheumatoid factor in the blood is most often measured in U/ml, but IU/ml can also be found. Experts believe that the following values ​​are considered normal: 0 – 14 IU/ml or 10 U/ml. This amount may occur in older people.

Also another way to determine the norm is dilution. If we take a ratio of 1:20, where one unit of blood is diluted with twenty units of saline, then a healthy person has RF in in this case impossible to detect. But low concentration is not always proof of thriving health.

Doctors may refer you to full examination, even if the blood test is within normal limits. Because the presence of RF is an indicator of the development of many diseases. Also, the disease can develop over several months, and the tests will be negative. Only after the condition worsens will the rheumatoid factor be positive and exceed the norm.

An increase in the rheumatoid factor rate by 2-4 times is a sign of development serious illnesses, including: Sjögren's syndrome, liver cirrhosis and many others.

Analysis of rheumatoid factor detection

The essence of the analysis is that if there is rheumatoid factor in a person’s serum, it will react with antibodies from the test. Scientists called this test the Waaler-Rose reaction. A latex test, a carbo test or a carbo-globulin test are also performed.

Testing for rheumatoid factor involves examining venous blood. And the patient must comply with several instructions:

• do not eat for 8-12 hours before the test;
• drink only clean water;
• quit smoking by at least, for a day;
• exclude severe physical activity the day before the analysis;
• Remove fatty and fried foods and alcohol from your diet for 1 day.

If you notice signs of rheumatoid arthritis, you should immediately consult a doctor for testing. It is much better to undergo all possible tests, because this is how the doctor will get an overall picture of your condition. He will be able to compose individual program treatment.

In what diseases is rheumatoid factor detected?

Blood tests are the most common among doctors because they can help diagnose a large number of diseases or have time to detect disturbances in the functioning of the body. A test for rheumatoid factor is the first recommendation of a rheumatologist. But you should always remember that A positive RF test may indicate the development of more than just arthritis.

Unfortunately, not all diseases can be diagnosed using RF analysis. Children may develop juvenile rheumatoid arthritis, but a blood draw will not detect it.

Rheumatoid arthritis

Rheumatoid arthritis is serious disease which amazes small joints fingers and toes. Experts identify several types of rheumatoid arthritis, including Still's syndrome, which occurs in adolescents. There are several ways to detect this disease. The RF blood test is the most common, but it gives results only in the very early stages. In more advanced forms, the results may be negative.

Doctors note an increase in the P factor in patients with Felty syndrome. This is a rare form of rheumatoid arthritis, which is characterized by leukopenia, as well as a very acute initial stage of development.

Enough for a long time It was believed that detection of RF in a blood test was possible only in arthritis, and a diagnosis of seropositive rheumatoid arthritis was made. But recent research has proven that The P factor can also be observed in an absolutely healthy person. Because of this, the blood test is mainly auxiliary when making a final diagnosis.

Other diseases

Rheumatoid factor in the blood can be a sign various diseases. Both viral and bacterial in nature, and malignant neoplasms. Thus, the following ailments can act as a provocateur of an increase in the Russian Federation:

• flu;
• syphilis;
• tuberculosis;
• viral hepatitis;
• leprosy;
• Infectious mononucleosis;
• bacterial endocarditis.

Human internal organs, like joints, influence the level of RF. If the patient suffers from various chronic lung diseases, such as: sarcoidosis, interstitial pulmonary fibrosis or pneumosclerosis. A diseased liver also contributes to a positive test.

Among the most common ailments are:

• cirrhosis of the liver;
• mixed essential cryoglobulinemia;
• active chronic hepatitis.

In addition to diseases, rheumatoid factor is also influenced by malignant neoplasms. After chemotherapy sessions or radiation therapy doctors note an increase in RF. Lymphomas can also cause this reaction. To more rare cases include increased antibodies in Waldenström's macroglobulinemia and multiple myeloma.

Knowing the basic facts will help a person not be afraid to undergo tests. Information preparation will help the patient not to experience unnecessary stress when taking blood and calmly wait for the results of all checks. Also, having information about the symptoms will help the patient react in time and consult a doctor for help.

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A blood test to determine its composition allows you to determine whether a person has pathological abnormalities. Rheumatoid factor (rheumatic factor) is one of the indicators in a blood test, which can be defined as a set of aggressive autoantibodies that, under the influence of certain factors, attack body tissues, recognizing them as foreign.

RF is detected in a blood test in 80% of people suffering from – pathology connective tissue, in which multiple joint damage occurs.

General characteristics of the indicator

A rheumatic factor is a protein that has changed under the influence of pathogenic microorganisms and therefore is perceived by the immune system as a foreign object. Under such conditions, the body begins to actively produce antibodies. Initially, immunoglobulins, which represent rheumatoid factor, are produced only by the joint that has been subjected to pathological changes, but subsequently they begin to produce it as well Bone marrow, The lymph nodes, spleen. Autoantibodies penetrate into the blood and form circulating immune complexes.

Certain rheumatic factor (RF) values ​​have been established that are normal for humans; these indicators are different for individuals belonging to different age groups, but at the same time, in women and men, rheumatoid factor is contained within the same framework.

Identification of the rheumatic factor is one of possible methods diagnosing

The value of a blood test for rheumatoid factor

Rheumatic tests are required in the following cases:

• in the diagnosis of rheumatoid arthritis (RA);
• for the purpose of differentiating RA from other joint pathologies;
• during treatment of RA.

Increased rheumatoid factor is also observed in the presence of the following diseases and abnormalities:

• systemic lupus erythematosus;
• infectious viral pathologies;
• tuberculosis;
• gout;
• syphilis;
• sarcoidosis;
• Sjögren's syndrome, chronic illness connective tissue;
• malaria;
• hepatitis;
• lung and kidney diseases;
• malignant neoplasms.

At positive analysis for the rheumatic factor, it is considered that one of 7 possible diagnostic criteria rheumatoid arthritis. In order to confirm the diagnosis, it is enough to obtain positive results from four of them.

Norms of indicators

A healthy person usually does not have such an indicator as rheumatoid factor: it is observed only when the immune system malfunctions, although in this case there are exceptions. However, there are normal criteria that have different indicators for each age group.

RF is detected not only in adults, but also in children younger age, as well as teenagers. For this category, the norm is a blood serum level of 12.5 U/ml or less. In adult women and men, the rheumatic factor norm will be 12.5-14 U/ml.

In older people, the norm is considered to be as little as possible low level: over 50 years of age normal conditions it should not exceed 10 U/ml.

Even minor deviations of the RF readings from normal level may indicate a risk of developing dangerous pathologies.

In addition to a blood test for rheumatic factor, the following measures will help confirm the diagnosis:

• general analysis blood;
• general urine analysis;
• blood protein electrophoresis;
• rheumatic tests;
• analysis of synovial fluid.

After receiving the results of specific tests, further tactics of action are determined.

Input data and equipment used

The material for the study is blood serum. The unit of measurement is U/ml.

To conduct the study, a special centrifuge is used, through which blood is passed. Thanks to this equipment, the liquid part of the blood, the serum, is separated. You can work with it for 24 hours, no more, and the permissible temperature ranges from +2 to +70 degrees.

If rheumatic factor is present in the serum, it will react with certain antibodies.

How to prepare for the analysis?

To obtain reliable results, it is necessary to approach the preparation preceding the analysis correctly. You should:

• do not eat food 8-12 hours before blood sampling;
• the day before the test, do not smoke, do not drink alcohol, do not eat fried or fatty foods;
• do not take any medications a week or two before blood sampling;
• Before the analysis, drink only clean, non-carbonated water, and drinking coffee, juice, tea, and other drinks is prohibited;
• You cannot engage in heavy physical labor.
• Blood is taken in the morning, on an empty stomach.

How is the analysis done?

A blood test to detect rheumatoid factor can be carried out based on several methods:

It should be borne in mind that a negative test for rheumatoid factor does not indicate the absence of the disease. In the initial stages of the disease, RF cannot be detected in the blood, although joints enlarge and become deformed due to the formation of antibodies.

Research results

To assess the degree of risk of rheumatoid factor for the body, the following criteria are used:

• slightly increased level(from 25 to 50 U/ml);
• elevated (from 50 to 100 U/ml);
• significantly increased (more than 100 U/ml).

To confirm the diagnosis, carry out ultrasonography affected areas, X-ray examination limbs, as well as analysis for C-reactive protein.

The study result may be distorted due to factors such as the patient's age. The older the person, the higher the rate of false positive results.

It happens that increased rheumatoid factor is observed in healthy people. Such cases are extremely rare and there is no sufficient justification for such a phenomenon. This phenomenon is called a false elevated result. Causes of increased rheumatic factor in healthy people:

• if an allergic reaction occurs;
• in the presence of antibodies to viruses (for example, when carrying certain forms of hepatitis);
• with mutation of antibodies, which is caused by the activity of bacterial microorganisms.

In some cases, increased RF is noted in women in postpartum period. It doesn't require specific treatment– Over time, the indicator stabilizes to normal limits.

In children during the period of active growth (up to 16 years), the indicator may also be increased. Besides, similar phenomenon watch after suffered by the child viral infectious diseases.

Rheumatoid factor – specific indicator blood, which indicates predominantly connective tissue diseases.

In the presence of such pathologies, a specific reaction of the body occurs - the production of antibodies, provoked by the activity of the immune system. A positive test result indicates the presence of rheumatoid arthritis, a malignant tumor, Sjogren's syndrome or some other pathologies.

At medical examinations And diagnostic procedures A blood test is especially important. This biological substance reflects the health of all body systems and the functioning of internal organs. But few patients think about why rheumatoid factor is needed in a blood test. This indicator is associated with rheumatoid arthritis. But even if a person does not have arthritis, rheumatoid factor (RF) helps identify other, no less dangerous diseases, for example rheumatic endocarditis.

What is the Russian Federation

The medical indicator known as rheumatoid factor belongs to a group of autoantibodies. What it is? These particles are formed in joints and connective tissue as a result of damage to the body by inflammatory processes and certain diseases. The antibodies then enter the bloodstream and react with other groups of antibodies. Cells produced under the influence of the disease are type M immunoglobulins. This type of antibody becomes autoantibodies and attacks other immunoglobulins, which leads to the development of serious pathological disorders. The test is also known to patients as a blood test for rheumatism, but the RF indicator can be elevated in various diseases.

The normal range is 0–14 IU/ml if the laboratory uses IU or International Units as a measure. This is the standard value accepted in the medical community different countries. Content standards various types substances in one IU are established by WHO. Some domestic laboratories measure rheumatoid factor in U/ml, that is, in Action Units, which have a different value.

• The normal content of rheumatoid factor in a blood test is 0–10 U/ml.
• The norm is considered to be slightly exceeded when the RF value is 25–50 IU/ml.
• The indicator is elevated and medical intervention is required when the rheumatoid factor content in the blood test is 50–100 IU/ml.
• The norm is significantly exceeded if the test result shows an increase in RF by more than 10 IU/ml.

Purpose of analysis

Autoantibodies can be detected in the laboratory by examining a biological sample. A blood test for rheumatoid factor can be prescribed not only by a rheumatologist. Often, a referral for medical tests is issued by a local physician, traumatologist or other doctor for appropriate indications.

• Symptoms indicating rheumatoid arthritis. Redness of the joints, painful sensations when moving and bending the joint, often accompanied by swelling. A feeling of stiffness and difficulty in moving the joint is usually noted in the morning.
• The RF indicator is determined during the treatment of rheumatoid arthritis as prescribed by a doctor to monitor the effectiveness of the prescribed therapy.
• Carrying out diagnostics of various diseases of joints and connective tissue.
• An analysis for RF in the blood can be prescribed if a patient has cardiovascular diseases (rheumatic endocarditis, pericarditis, etc.).
• Suspicion of Sjögren's Syndrome. This disease does not affect the joints themselves, but the connective tissues. The syndrome quickly becomes chronic and affects various glands. It occurs more often in women, and with recurrence the risk of the disease increases.
• Diagnosis of diseases caused by disorders of the human immune system or its individual components (autoimmune diseases).

Determining rheumatoid factor in a blood test is usually not the only medical test that is prescribed to a patient. The research is carried out comprehensively and includes general tests blood and urine, ESR, biochemical analysis for liver enzymes (ALT, AST, bilirubin, etc.), blood protein electrophoresis and other tests. The number and types of laboratory tests are determined by the attending physician. In some cases, the disease is diagnosed even if the RF is normal.

How is the analysis carried out?

The most accurate and widespread method of testing blood for rheumatoid factor is considered linked immunosorbent assay blood (ELISA). This type of study searches for antibodies and determines their quantity. In this case, during a laboratory test, antibodies of types A, E, G and M are analyzed. Other types of studies (Waaler-Rose and latex test) are inferior in accuracy to ELISA and are not able to detect antibodies other than type M, which become autoantibodies. The analysis expands diagnostic capabilities.

Thus, an increase in type A antibodies indicates severe manifestations of rheumatoid arthritis, and an increase in type G indicates the concomitant development of vesiculitis.

Blood tests are carried out in laboratory conditions in municipal and commercial medical institutions. The day before submitting the sample, it is recommended to refrain from eating fatty, fried foods and sugary drinks. You should not drink alcohol or smoke for several days before the test. About accepting any medicines You should inform your doctor in advance; you may have to stop taking medications 1-2 weeks before blood sampling.

Increased factor

Exceeding the established norm as a result of a blood test for RF is not an accurate indication of a specific disease. Other indicators are also used to confirm the doctor’s suspicions. Rheumatoid factor can increase as a result of various autoimmune, infectious and other diseases.

• Rheumatoid arthritis is a diagnosis that corresponds to 80% of patients in whom RF is elevated. Medical statistics claim that every hundredth inhabitant of our planet is susceptible to this disease, and 80% of them are women. Arthritis affects the joints of the hands and feet. On initial stage the disease is asymptomatic, then pain begins to appear when moving the joint, inflammation and redness of the skin.
• Exceeding the norm in a blood test for RF can also accompany other autoimmune diseases. The inflammatory process can affect connective tissues (Sjögren's syndrome), vessels of arteries, veins and capillaries (vasculitis), spinal joints (Bechterov's disease), complex damage to blood vessels, connective tissue and internal organs (systemic scleroderma) and others.
• In inflammatory processes in the lungs, liver or kidneys, the rheumatoid factor is increased.
• Pathological conditions in which granulomas form increase the RF level in the patient’s blood. The appearance of dense nodules (granulomas) affects internal organs, skin, eyes, etc. The most common are silicosis, anthracosis, sarcoidosis and other diseases.
• Severe infectious diseases (malaria, tuberculosis, etc.).
• The appearance of autoantibodies can be caused by the development malignant tumors bone marrow.

Some cardiovascular diseases directly related to the fact that the patient’s rheumatoid factor is elevated. Pericarditis is characterized by a high RF and ESR, as well as a low glucose level. Patients complain about aching pain in the chest area, which become worse when coughing and deep breaths. Symptoms are often accompanied by rapid pulse and shortness of breath. Rheumatic myocarditis accompanies high rate rheumatoid factor and ESR, an additional biochemical analysis is performed. Rheumatoid heart defects develop with long-term arthritis. Often this disease is asymptomatic for the patient and is detected during a medical examination.

With frequent inflammatory diseases, joint lesions, the doctor directs the patient to take a test for rheumatoid factor (RF). Its presence and concentration in the blood will tell the specialist a lot. The study will not only help establish an accurate diagnosis, but also predict the further course of the disease.

What is the Russian Federation

Rheumatoid factor appears in the blood when the immune system fails. It is an antibody that reacts as a self-antigen with its own immunoglobulins IgG class. Most often, RF refers to IgM, much less often to IgA, IgD, IgG.

Autoantigens that react with one’s own antibodies are extremely dangerous. RF forms a stable circulating complex with immunoglobulin, which has a cytotoxic effect. He:

• damages synovium joints;
• causes inflammation;
• has a destructive effect on the vascular wall.

Accordingly, due to its occurrence, the patient experiences joint pain. And for an accurate diagnosis, the doctor needs to know not only the presence, but also the concentration of RF in the blood. Directed by:

• if you suspect;
• to monitor the treatment of the disease;
• for diagnostics;
• for chronic inflammatory diseases.

To determine its concentration, the ability of RF to agglutinate (glue together) red blood cells in the presence of immunoglobulins is used. This is one of the manifestations of the reaction between it and ordinary antibodies.

Rheumatoid factor is detected using various methods:

• latex agglutination;
• Waaler-Rose reaction;
• nephelometry;
• enzyme immunoassay (ELISA).

Most often, they are used to determine RF related to IgM. But identifying autoantibodies of classes G, A and D is much more difficult. That is why, with a seronegative (negative) reaction in the presence of clinical symptoms diseases recommend other clarifying diagnostic methods.

The reaction is considered positive if agglutination occurs at a dilution of 1:40 or 1:20 (modified Speransky method). Due to use different ways determination of RF in clinical laboratories, repeated tests must be carried out in the same place where the analysis was initially taken.

What does the presence of the Russian Federation indicate?

To identify the cause of the lesion, monitor the course of the disease, and predict the occurrence of complications, the clinician must know not only the presence of RF, but also its concentration. It is considered normal if the RF is no more than 25-30 IU/ml.

1. High RF values ​​(increase in concentration by 2-4 times) indicate rheumatoid arthritis, autoimmune diseases affecting connective tissue. And the more of it, the more severe the disease. A high titer also indicates infectious diseases, serious pathologies liver.
2. RF is detected in small quantities even in healthy people. Although many experts believe that this indicates high probability the appearance of rheumatoid arthritis in the future.
3. Patients with rheumatoid arthritis sometimes have negative serological reaction(seronegative variant of the disease). That is why repeated tests are necessary, as well as examination by an orthopedist, other clinical researches(for the presence of protein and protein fractions, fibrinogen, glycosaminoglycan, sialic acids, etc.), radiography of joints.

In 50-90% of cases, the presence of RF in the blood indicates rheumatoid arthritis. In patients with a very high titer, severe extra-articular lesions occur and actively progress destructive processes and the prognosis for the course of the disease is unfavorable.

Using an RF analysis, an orthopedic doctor evaluates the activity of the process, and this is necessary when determining:

• the feasibility of the operation;
• effectiveness of treatment;
• the possible course of the disease and the occurrence of complications;
• risk of developing cardiovascular pathologies.

To diagnose rheumatoid arthritis, a blood test for RF is not enough. After all, the reaction can be seronegative. Reasons for this:

1. In laboratories, autoantibodies of the IgM class are most often detected, and the disease can be triggered by antibodies of the IgA, IgD IgG classes (such antibodies are much more difficult to detect).
2. Errors in the analysis. This is why repeated studies are needed.
3. Initial stage of the disease. An increase in titer occurs 6-8 weeks after the onset of the first symptoms.
4. Only those autoantibodies that are not complexed with immunoglobulin are detected in the blood.

RF is also detected in other pathologies:

• systemic lupus erythematosus (accompanied by joint damage);
• polymyositis;
• infectious diseases (,);
• pulmonary fibrosis;
• macroglobulinemia;
• malignant neoplasms.

Rheumatoid factor can be detected even in the blood of a newborn with congenital cytomegaly, as well as in women who have given birth many times, and people over 70 years old, so only a doctor can make an accurate diagnosis.

Which doctor should I contact?

Rheumatoid factor, which is an autoantibody, when reacting with immunoglobulins, has a destructive effect on the joints. And its appearance in the blood indicates that the patient has rheumatoid arthritis, another autoimmune or infection. A very high RF titer signals an extremely severe course diseases. Its presence in the blood is determined in clinical laboratories. A rheumatologist refers him for research. An orthopedist, neurologist or neurosurgeon can prescribe such a study if the patient comes to them with complaints of pain in the spine, joints, and limited movement.

A rheumatoid blood test is prescribed to diagnose rheumatoid arthritis, sarcoidosis, autoimmune diseases, systemic diseases acute inflammatory processes. Immunoglobulins specific to the Fc region of IgG are called rheumatoid factor. Their content in the blood should be What if the test for rheumatoid factor

Blood to determine rheumatoid factor in the morning, on an empty stomach (after eight to twelve hours from the last meal), at this time you are allowed to drink only clean water. It is recommended to refrain from smoking the day before blood collection. The amount of RF increases sharply with systemic manifestations of rheumatoid arthritis. At obvious signs disease, a test for rheumatoid factor may also be negative and not change for several months.

The test result can be positive not only for rheumatoid, but also for primary syndrome Sjögren, diseases with unknown causes - sarcoidosis, various systemic connective tissue lesions (dermatomyositis, lupus erythematosus, scleroderma). TO positive result Many chronic infections can also result (syphilis, tuberculosis, chronic hepatitis, malaria), in these cases the number of antibodies is much lower.

If you have symptoms similar to rheumatoid arthritis and test results, you should urgently contact. If rheumatoid factor is detected in a healthy person, any risk of developing the disease should be minimized, hypothermia should be excluded, bad habits, get rid of possible foci of chronic infection (sinusitis, caries).