Rheumatoid arthritis laboratory tests

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Overview

Laboratory tests used to diagnose rheumatoid arthritis include complete blood count with differentials, erythrocyte sedimentation rate, CRP, renal function test, LFTs, and antibodies such as rheumatoid factor, anti-CCP, and anti MCV.

Laboratory Findings

Following tests are used to make the diagnosis of rheumatoid arthritis:^[1]^[2]

Complete blood count with differentials
- Low haemoglobin
- Neutropenia
Platelet count
- Thrombocytosis
Acute phase reactant are used to measure disease progression:^[3]
- Erythrocyte sedimentation rate
- C-reactive protein: CRP gives an idea about the radiological progression and mean CRP correlates with articular index
Renal function test – usually dearranged in complication of RA
Liver function test – abnormal in complication of RA
Antibodies
- Rheumatoid factor:
  - It has mean specificity of 79%, with sensitivity of about 60%^[4]^[5]
- Antibodies to cyclic citrullinated peptides (anti-CCP antibodies):^[6]^[7]
  - It has specificity of about 81-100%, with sensitivity of 39–94%
- Antibodies to citrullinated vimentin and mutated citrullinated vimentin (MCV):
  - It has specificity of about 90.3–98%, with sensitivity of 69.5–82%

References

↑ Bayliss CE, Dawkins RL, Cullity G, Davis RE, Houliston JB (October 1975). “Laboratory diagnosis of rheumatoid arthritis. Prospective study of 85 patients”. Ann. Rheum. Dis. 34 (5): 395–402. PMC 1006439. PMID 769705.
↑ Wasserman AM (December 2011). “Diagnosis and management of rheumatoid arthritis”. Am Fam Physician. 84 (11): 1245–52. PMID 22150658.
↑ van Leeuwen MA, van Rijswijk MH, van der Heijde DM, Te Meerman GJ, van Riel PL, Houtman PM, van De Putte LB, Limburg PC (June 1993). “The acute-phase response in relation to radiographic progression in early rheumatoid arthritis: a prospective study during the first three years of the disease”. Br. J. Rheumatol. 32 Suppl 3: 9–13. PMID 8508266.
↑ Heidari B (2011). “Rheumatoid Arthritis: Early diagnosis and treatment outcomes”. Caspian J Intern Med. 2 (1): 161–70. PMC 3766928. PMID 24024009.
↑ Dörner T, Egerer K, Feist E, Burmester GR (May 2004). “Rheumatoid factor revisited”. Curr Opin Rheumatol. 16 (3): 246–53. PMID 15103252.
↑ van Venrooij WJ, Hazes JM, Visser H (November 2002). “Anticitrullinated protein/peptide antibody and its role in the diagnosis and prognosis of early rheumatoid arthritis”. Neth J Med. 60 (10): 383–8. PMID 12607587.
↑ Schellekens GA, Visser H, de Jong BA, van den Hoogen FH, Hazes JM, Breedveld FC, van Venrooij WJ (January 2000). “The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide”. Arthritis Rheum. 43 (1): 155–63. doi:10.1002/1529-0131(200001)43:1<155::AID-ANR20>3.0.CO;2-3. PMID 10643712.

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[pmid769705-1] Bayliss CE, Dawkins RL, Cullity G, Davis RE, Houliston JB (October 1975). “Laboratory diagnosis of rheumatoid arthritis. Prospective study of 85 patients”. Ann. Rheum. Dis. 34 (5): 395–402. PMC 1006439. PMID 769705.

[pmid22150658-2] Wasserman AM (December 2011). “Diagnosis and management of rheumatoid arthritis”. Am Fam Physician. 84 (11): 1245–52. PMID 22150658.

[pmid8508266-3] van Leeuwen MA, van Rijswijk MH, van der Heijde DM, Te Meerman GJ, van Riel PL, Houtman PM, van De Putte LB, Limburg PC (June 1993). “The acute-phase response in relation to radiographic progression in early rheumatoid arthritis: a prospective study during the first three years of the disease”. Br. J. Rheumatol. 32 Suppl 3: 9–13. PMID 8508266.

[pmid24024009-4] Heidari B (2011). “Rheumatoid Arthritis: Early diagnosis and treatment outcomes”. Caspian J Intern Med. 2 (1): 161–70. PMC 3766928. PMID 24024009.

[pmid15103252-5] Dörner T, Egerer K, Feist E, Burmester GR (May 2004). “Rheumatoid factor revisited”. Curr Opin Rheumatol. 16 (3): 246–53. PMID 15103252.

[pmid12607587-6] van Venrooij WJ, Hazes JM, Visser H (November 2002). “Anticitrullinated protein/peptide antibody and its role in the diagnosis and prognosis of early rheumatoid arthritis”. Neth J Med. 60 (10): 383–8. PMID 12607587.

[pmid10643712-7] Schellekens GA, Visser H, de Jong BA, van den Hoogen FH, Hazes JM, Breedveld FC, van Venrooij WJ (January 2000). “The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide”. Arthritis Rheum. 43 (1): 155–63. doi:10.1002/1529-0131(200001)43:1<155::AID-ANR20>3.0.CO;2-3. PMID 10643712.

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