Re: Rheumatoid Factor Associated With Smoking inArthritis Patients

[Guest guest]

Hi, a and Sue.

I believe Sue is reporting a rheumatoid factor (RF) test result of 170

IU/mL not a 1:70 titer (the nephelometric method not the agglutination

method).

If your lab cutoff for normal is 20 IU/mL, Sue, 170 IU/mL would be

considered high. Just how high, I'm not sure. The labs I've checked

recently and in the past just consider levels beyond the normal range to

be positive and don't elaborate beyond that. Interpretation is left to

the physician.

I did see your original post, Sue, and I've been looking around to find

out if anyone would be willing to commit to quantifying what is meant by

low, moderate, moderately high, high, very high, and so on. So far,

nada, but that doesn't surprise me since I believe we still don't know

enough about RF to be able to do that. Right now, it would be fairly

difficult to be able to associate significance to various levels of this

protein and come up with a standard. I know that it's frustrating to

read some of these studies because terms currently used like " high " are

so relative and subjective, almost meaningless to the reader. To

complicate matters even further, there is no one standard measurement

technique for RF.

If I understand what your underlying question is, you are wondering what

your rheumatoid factor level means in terms of your prognosis. Is that

correct?

While it is generally (emphasis here!) true that people who have

rheumatoid arthritis (RA) who test positive for RF usually have more

severe disease in the long run and of those who have RF those who have

the highest titers are more likely to be more seriously affected than

those with lower titers, exceptions abound.

Also, it is very important to keep in mind that RF is in no way specific

to RA. There isn't even consensus on what it means in RA. Does it

contribute to more severe disease or is it produced in such cases? Cause

or effect? Does it perhaps have a protective function or is it

destructive? These are all unknowns.

If I were you, Sue, I wouldn't worry about it too much.

Although this book of mine is now getting old, here is a paragraph that

I believe still holds true and illustrates an important concept:

" The most common concerns expressed by patients with recently diagnosed

RA relate to immediate effect on lifestyle, work and family, and

long-term outcome. It remains surprisingly difficult to provide accurate

prognostic information in an individual; this is frustrating for patient

and physician alike. While seropositivity, high acute-phase

measurements, involvement of many joints, poor function as measured by

initial Health Assessment Questionnaire (HAQ), early erosion on X-ray

and the possession of disease-associated alleles are all associated with

a worse prognosis, exceptions are frequent, and no single test or

combination of tests gives entirely reliable information. Thus, an

overall assessment of prognosis is both challenging and notoriously

unreliable. "

An excerpt from " Challenges in Rheumatoid Arthritis " edited by A.

Bird and L. Snaith, Blackwell Science, 1999.

Re: [ ] Rheumatoid Factor Associated With Smoking

inArthritis Patients

Sue,

Sorry I missed this post Sue. I¹m glad you resent it.

The way rheumatoid factor is determined is sometimes confusing. Your

lab

says that 1:20 is considered normal. This means that they diluted your

sample 20 times and found RF. They then dilute it again to 40 times

(1:40)

and they still can detect RF. So they dilute it again to 60 times

(1:60)

and they still can detect it. Yours is 1:70 meaning they diluted it 70

times and can detect some RF. But any dilutions over 1:70, they

couldn¹t

find any RF. Labs are different, but many consider anything over 1:80

as

being positive, so yours isn¹t considered very high.

Here is some info:

http://www.nlm.nih.gov/medlineplus/ency/article/003548.htm

http://www.labcorp.com/datasets/labcorp/html/chapter/mono/se024700.htm

a

>

>

> on 9/20/02 10:31 PM, Sue Plaster2 at splaster@... wrote:

>

> I didn't receive any response to this, so I'm sending it again. Sue

>

>> > on 9/20/02 5:26 PM, a at paula54@... wrote:

>>> >>

>>> >> " One of the implications of our findings is that smoking may

increase the

>>> >> severity of RA by inducing the production of RF, " Dr. Mattey told

Reuters

>>> >> Health. " In certain individuals their genetic make-up alone will

make >>>

them

>>> >> more likely to produce RF, " he said. " However, if they smoke as

well, it

is

>>> >> likely to increase the risk of producing RF and may exacerbate

the

>>> severity

>>> >> of their disease. "

>> >

>> > I smoked for over 30 years before I quit about eight years ago.

Last August

>> > when I was diagnosed with RA, my Rheumatoid Factor was 170 IU/ml

(Reference

>> > Range < 20 IU/ml). But I have nothing to compare that to. Is that

very high

>> > or moderately high or what?

>> >

>> > Sue in NC

[Guest guest]

Thanks , and I¹m sorry Sue. You send it twice and I still don¹t get it

right. I wish they would standardize this test so it was easier to

interpret. This is one reason I hesitate to answer these type questions and

just sent a link in to read. you¹re an angel!

a

> Hi, a and Sue.

>

> I believe Sue is reporting a rheumatoid factor (RF) test result of 170

> IU/mL not a 1:70 titer (the nephelometric method not the agglutination

> method).

>

> If your lab cutoff for normal is 20 IU/mL, Sue, 170 IU/mL would be

> considered high. Just how high, I'm not sure. The labs I've checked

> recently and in the past just consider levels beyond the normal range to

> be positive and don't elaborate beyond that. Interpretation is left to

> the physician.

>

> I did see your original post, Sue, and I've been looking around to find

> out if anyone would be willing to commit to quantifying what is meant by

> low, moderate, moderately high, high, very high, and so on. So far,

> nada, but that doesn't surprise me since I believe we still don't know

> enough about RF to be able to do that. Right now, it would be fairly

> difficult to be able to associate significance to various levels of this

> protein and come up with a standard. I know that it's frustrating to

> read some of these studies because terms currently used like " high " are

> so relative and subjective, almost meaningless to the reader. To

> complicate matters even further, there is no one standard measurement

> technique for RF.

>

> If I understand what your underlying question is, you are wondering what

> your rheumatoid factor level means in terms of your prognosis. Is that

> correct?

>

> While it is generally (emphasis here!) true that people who have

> rheumatoid arthritis (RA) who test positive for RF usually have more

> severe disease in the long run and of those who have RF those who have

> the highest titers are more likely to be more seriously affected than

> those with lower titers, exceptions abound.

>

> Also, it is very important to keep in mind that RF is in no way specific

> to RA. There isn't even consensus on what it means in RA. Does it

> contribute to more severe disease or is it produced in such cases? Cause

> or effect? Does it perhaps have a protective function or is it

> destructive? These are all unknowns.

>

> If I were you, Sue, I wouldn't worry about it too much.

>

> Although this book of mine is now getting old, here is a paragraph that

> I believe still holds true and illustrates an important concept:

>

> " The most common concerns expressed by patients with recently diagnosed

> RA relate to immediate effect on lifestyle, work and family, and

> long-term outcome. It remains surprisingly difficult to provide accurate

> prognostic information in an individual; this is frustrating for patient

> and physician alike. While seropositivity, high acute-phase

> measurements, involvement of many joints, poor function as measured by

> initial Health Assessment Questionnaire (HAQ), early erosion on X-ray

> and the possession of disease-associated alleles are all associated with

> a worse prognosis, exceptions are frequent, and no single test or

> combination of tests gives entirely reliable information. Thus, an

> overall assessment of prognosis is both challenging and notoriously

> unreliable. "

>

> An excerpt from " Challenges in Rheumatoid Arthritis " edited by A.

> Bird and L. Snaith, Blackwell Science, 1999.

>

>

[Guest guest]

a, you're welcome. I too wish they would standardize the rheumatoid

factor test - in fact, all of the common tests in rheumatology. There is

so much misunderstanding and confusion where these tests are concerned.

No wonder!

Re: [ ] Rheumatoid Factor Associated With Smoking

inArthritis Patients

Thanks , and I¹m sorry Sue. You send it twice and I still don¹t get

it

right. I wish they would standardize this test so it was easier to

interpret. This is one reason I hesitate to answer these type questions

and

just sent a link in to read. you¹re an angel!

a

[Guest guest]

,

Thank you so much for the information on the Rheumatoid Factor. I was

responding to an article sent by a that stated that smoking may increase

the severity of RA by inducing the production of RF. I was a heavy smoker

for over 30 years, and I've read before that smokers or former smokers may

have more severe cases of RA.

Actually, though, I have wondered about my prognosis. Besides the smoking, I

have read about some other factors that indicate a worse prognosis. It seems

that I fit into a lot of those categories. Here are some that I remember:

Getting the disease after the age of 50 (Mine started last Jan. when I

was 61.)

Early knee involvement (Mine gave me trouble after only a few months.)

Rheumatoid nodules (Mine appeared a few months ago.)

Having a high RF

When I was diagnosed last August, my other tests were as follows:

Sedimentation Rate 105 (Normal 0-30)

C-Reactive Protein 12.2 (Normal 0.0-1.0)

I don't know if these are high or low, as I have nothing to compare them to,

either.

I am going to take your advice and try not to worry about my prognosis. I am

thankful that I didn't get it when I was young and trying to work and raise

a family. I am thankful that I have an excellent rheumatologist to help me.

I remember last year when I couldn't open a bottle or jar, squeeze out a

dish cloth, much less a mop, or even cut my own meat at times. Now I am able

to do all of those things. I still can't do all the things that I used to

be able to do, but I can manage in all aspects of my daily living.

I am on medication now (mtx, Arava, and Bextra) that has made my pain almost

completely disappear. My liver is holding up so far. My white cell count is

low so I don't have a lot of energy, but I have the option of sleeping late

(and I usually do). I'm still stiff and my knees don't like to bend all that

much, but I can manage quite nicely. I am thankful for that, too.

I am also thankful for this list, giving me support and comfort. And I'm

especially thankful for you and a for all the information you round up

for us. You are both angels.

Sue in NC