RA factor is a protein (antibody) that is measurable in the blood with a routine blood test. A positive RA factor test means that level of rheumatoid factor in patient’s blood is high. A positive RA factor test is mainly used as a supportive tool in making the diagnosis of rheumatoid arthritis.
Our immune system produces healthy proteins (antibodies) that fight off infections caused by bacteria and viruses. Sometimes, bad antibodies are produced by the immune system which can attack healthy tissue. RA factor is a bad antibody protein produced by patient’s immune system.
It is unknown what triggers our immune system to produce rheumatoid factor. It is thought to be a combination of genetics and other external risk factors.
RA factor test is used by doctors to help in diagnosing rheumatoid arthritis. Approximately 70% of rheumatoid arthritis patients test positive for RA factor.
A negative RA factor test does not rule out the diagnosis of rheumatoid arthritis. In fact, there is no single test to diagnose rheumatoid arthritis. The diagnosis is made from a combination physical symptoms and medical history supported by various blood tests such as RA factor, anti-CCP antibodies and elevated inflammatory markers. Newer tests like anti-CCP antibodies are much more specific for rheumatoid arthritis.
Patients who test negative for RA factor but have signs and symptoms may still be diagnosed with rheumatoid arthritis. This is seen in around 30% patients with rheumatoid arthritis (seronegative).
Rheumatoid arthritis affects different patients in different ways. Rheumatoid arthritis patients with a positive RA factor test have the potential for a more aggressive disease course. Keep in mind this isn’t always the case. If RA factor is tested and symptoms are detected early, a diagnosis can be quickly reached. Treatment should be started as soon as possible to joint damage.
The level of RA factor can fluctuate during the course of the disease but it does not correlate with disease activity and it does not normalise with treatment. If you have rheumatoid arthritis, it is not necessary to monitor the level RA factor. Inflammatory markers such as ESR and CRP are often elevated during active disease and can be good markers to monitor treatment response.
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In the past, there were concerns that RA might affect the ability to conceive. But with recent advances, it is clear that if the disease is well controlled, most women with RA can have an enjoyable and successful pregnancy.
The risk of foetal loss or genetic abnormalities for women with RA is not significantly greater than for any other pregnant women.
Planning ahead is the key. Before you try to conceive, it’s important that you discuss with your rheumatologist.
It is recommended to become pregnant when the disease is not active.
All women who are planning to get pregnant should take folic acid supplements daily.
Many patients may not need RA medications during the pregnancy if their disease is not active. The pain and swelling associated with RA is much improved during pregnancy in up to 75% women.
Some of the drugs used to treat RA can be continued while trying to conceive or even during the pregnancy. It is advisable to consult with your rheumatologist before you stop any drugs.
Certain medications like methotrexate and leflunomide should be stopped well in advance. There are medications like sulfasalazine, hydroxychloroquine and steroids are safe during pregnancy and breastfeeding.
Although you may be concerned about the possible harmful effects of taking RA drugs, it is important to remember that uncontrolled arthritis during pregnancy can also have adverse effects on your baby such as low birth weight.
Treatment depends on the final diagnosis and severity of the disease.
1. Starts before the age of 40 years
2. Comes on slowly over time
3. Worse in the mornings and evening
4. Stiffness in the mornings or after period of inactivity
5. Improves with exercise and worse with rest
6. Can often cause pain in the buttocks
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To fight Rheumatoid Arthritis (RA), you have to understand the condition inside and out. Try to learn everything you can about this disease. It makes a huge difference if your initial experience of care is positive. As they say, a good beginning is half the battle won! Similarly, a correct diagnosis is the most important step.
In addition, the following are highly recommended for people living with RA
Chikungunya is a viral disease transmitted by Aedes mosquitoes to humans. It has nothing to do with chicken. The word chikungunya comes from Bantu language. It means that which bends up. This refers to the stooped posture patients frequently adopt due to severe joints and back pain.
Chikungunya virus infection is commonly diagnosed by the blood test that identifies the antibodies to the virus. The antibody test is called Chikungunya IgM antibody. It is usually requested after 5-7 days after symptom onset. The test may come as false negative in the first few days from symptom onset. The test can remain positive for several months.
Symptoms usually begin 3 – 7 days after being bitten by an infected mosquito. Common symptoms include fever and severe joint pains. Other symptoms may include a headache, muscle pain, joint swelling, backache or rash. Most patients will feel better within a week. In some people, the joint pain may persist for months.
All of us living in countries like India are at risk of catching chikungunya infection. People at risk for more severe disease include newborns infected around the time of birth, older adults (≥65 years), and people with medical conditions such as high blood pressure, diabetes, or heart disease.
Chikungunya Fever: varies from low grade to high grade, lasting for 24 to 48 hours. Fever rises abruptly in some, reaching 39-400 C, with shaking chills and rigor and usually subsides with use of antipyretics.
Chikungunya Joint Pain: Typically seen two to five days after onset of fever. Joint pains tend to be worse in the morning, relieved by mild exercise and exacerbated by aggressive movements. Joints of lower limbs -Ankles, knees – are commonly affected. Often, the arthritis is severe and debilitating, leading to immobilization due to pain.
The chronic phase of the disease, characterized by recurrent joint pain, can be seen in around 30-40% of those infected. It can last for years in some cases. This arthralgia can evolve to a chronic inflammatory arthritis (like rheumatoid arthritis).
Chikungunya Rash: Transient rash is seen in up to 50% patients(usually three days after fever), which starts on the limbs, can involve the face and may be patchy or diffuse. The skin lesions are itchy and exfoliative dermatitis is common.
Currently, there is no vaccine available. Preventing mosquito bites is the only way to reduce the risk of infection. Mosquitoes that spread chikungunya virus usually bite humans during the day – peak in the early morning and late afternoon.
If you have a family member with chikungunya infection
During the first week of infection, chikungunya virus can be passed from an infected person to a mosquito through mosquito bites. An infected mosquito can then spread the virus to other people. To prevent further spread of the virus, it is important for people to avoid mosquito bites during the first week of illness. The person should stay indoors or under a mosquito net.
Once a person has been infected, he or she is likely to be protected from future infections.
Treatment involves at relieving your symptoms of joint pains and fever. If you are experiencing symptoms of chikungunya virus infection, see a doctor immediately.