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Rheumatoid Factor

Rheumatoid factor (RF) refers to immunoglobulins that target the Fc region of IgG, with IgM and IgG being the most common types associated with rheumatoid arthritis (RA). RF positivity correlates with disease severity and other complications, and the presence of all three RF isotypes indicates a high specificity for RA. Various serologic tests, such as the Rapid Latex Agglutination Test and Rose-Waaler Test, are used to detect RF levels, which can indicate the presence of RA or other disorders.

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11 views1 page

Rheumatoid Factor

Rheumatoid factor (RF) refers to immunoglobulins that target the Fc region of IgG, with IgM and IgG being the most common types associated with rheumatoid arthritis (RA). RF positivity correlates with disease severity and other complications, and the presence of all three RF isotypes indicates a high specificity for RA. Various serologic tests, such as the Rapid Latex Agglutination Test and Rose-Waaler Test, are used to detect RF levels, which can indicate the presence of RA or other disorders.

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angelinaabeer00
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RHEUMATOID FACTOR

- immunoglobulins of any isotype with antibody activity directed against antigenic sites on the Fc region of
human or animal IgG
- RFs have been associated with three major immunoglobulin classes: IgM, IgG, and IgA
- IgM and IgG RFs are the most common; IgA indicates a more severe type of RA
- Immunoglobulin M rheumatoid factor is manifested in approximately 70% of adults but is not specific to RA.
- Being RF-positive correlates with the following:
o Severity of the disease (in general)
o Nodules
o Other organ system involvement (e.g., vasculitis, Felty’s syndrome, Sjögren’s syndrome)
- Agglutination tests for RF (routine serologic principle), such as the sensitized sheep cell test and latex
agglutination, generally detect IgM RFs
- The presence of abnormal levels of all three RF isotypes—IgM, IgG, and IgA—has a specificity of 99% for
Rheumatoid Arthritis
- Approximately 20% of children are positive for RF
- Most patients who are positive for RF probably represent adult RA occurring in childhood
- The determination of RFs is important in the prognosis and therapeutic management of rheumatoid
arthritis; however, biologically false-positive test results may be observed in a variety of disorders, such as
rheumatic fever, SLE, Sjögren’s syndrome, and hepatitis
- Significant titers:
o ≥80 = POSITIVE
o 20-40 = WEAKLY POSITIVE
o 1-20 = NEGATIVE

SEROLOGIC TESTS FOR RF

1. Rapid Latex Agglutination Test (Passive agglutination)


- Latex agglutination titer lower limit is based on an undiluted sample and diluted sample at 1:10
o If positive only in undiluted sample:
§ Very low titer (present also in other diseases such as SLE, endocarditis, tuberculosis, syphilis,
viral infection, and diseases of the liver, lung, or kidney)
§ Low titer can be found in approximately 1 percent of healthy individuals
o If positive at 1:10 dilution
§ RF is present in the specimen at a level generally associated with RA

2. Rose-Waaler Test: Sheep RBC agglutination test


3. Singer and Plotz Test: Latex fixation test (detects IgM RFs)

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