Guest guest Posted May 30, 2004 Report Share Posted May 30, 2004 Noreen, Higher titers do tend to correlate with more severe and sustained disease, joint deformities and nodules according to studies. Not all doctors seem to agree with this since they have seen seronegative patients have severe erosion. I am seronegative and have what the doctors consider severe erosion. Maybe in my case it is the length of time that I¹ve had the disease that correlates to the severity of erosion. My sed rates are always in the 40 to 50 range and before Enbrel, it was always in the 80¹s. Rheumatoid Factor as a Diagnostic and Prognostic Test Rheumatoid factor is a well-established diagnostic and prognostic test in RA. New studies support its usefulness in diagnosis; it is included along with the duration of symptoms, duration of morning stiffness, arthritis in three or more joint groups, metatarsophalangeal tenderness, and anti-CCP antibodies, in a scoring system developed to differentiate persistent arthritis from transient arthritis, and erosive arthritis from persistent nonerosive arthritis.[15] This scoring system was shown to have better discriminatory ability than the American College of Rheumatology classification criteria for RA. A study of the performance of commercially available ELISA test kits found large variation among the kits in ability to detect rheumatoid factor.[16] Antibodies to -enolase and calpastatin have been reported in patients with early RA, often in the absence of rheumatoid factor, but the low prevalence of these antibodies in patients with RA makes it unlikely that they will be useful as diagnostic tests.[17, 18] Three recent prospective studies of patients with early RA have confirmed that rheumatoid factor is a major predictor of bone damage as assessed by radiographs.[19-21] Patients with a positive rheumatoid factor were 2.5 times more likely to have rapid progression of Sharp/van der Heidje scores over 1 year follow-up than those who were seronegative for rheumatoid factor.[19] In the Norfolk Arthritis Register Study, patients with a rheumatoid factor titer of greater than 1:160 (latex) were 2.3 times more likely to have worsening of their Larsen scores over 5 years than those who were seronegative.[20] Finally, patients with a positive rheumatoid factor were 3.3 times more likely to develop severe radiographic damage over 12 years than were those who were seronegative.[21] In this latter study, rheumatoid factor status was not associated with functional disability or a persistently active course of RA. Higher urinary glucosyl-galactosyl-pyridinoline levels may also predict more rapid radiographic damage, but it is not clear if this is independent of, or a better predictor than, rheumatoid factor.[22] http://www.medscape.com/viewarticle/449856_2 a On 5/30/04 11:53 AM, " Noreen Saukko " <nsaukko@...> wrote: > My RA titer was 86. I don't think though, that the titer actually is an > indication of the severity of the disease. Is that correct and a? > Since a person can have RA and be seronegative, the actual number probably > is not that significant. > > I'm a lab tech, and whenever I'm having a bad day, I run a sed rate. (perks > for working in the lab, if you consider getting blood taken a perk). > Even when I've been feeling really sore, the highest my sedrate has been is > about 36. Sed rates of course, are only an indication of some sort of > inflammation, and are not specific to RA, but since I've seen many people > who have sedrates in the 90's to 100's, I have developed great sympathy. > If I " m having a flare at 36, people with those extremely elevated levels, > need to be commended for being able to move at all. So my question is, how > high have others sed rates been? Of course not everyone is nuts like me, and > had blood drawn on a whim, but if you have results, I'm curious. > > Noreen > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2004 Report Share Posted May 30, 2004 My sed rate at diagnosis was 105; RF, 170; and C-Reactive protein, 12.2. Sed rate and CRP had returned to normal some months later after I had been on Arava for a while. I would guess from the way that I feel that they are normal now, also. Sue On Sunday, May 30, 2004, at 11:53 AM, Noreen Saukko wrote: > My RA titer was 86. I don't think though, that the titer actually is an > indication of the severity of the disease. Is that correct and > a? > Since a person can have RA and be seronegative, the actual number > probably > is not that significant. > > I'm a lab tech, and whenever I'm having a bad day, I run a sed rate. > (perks > for working in the lab, if you consider getting blood taken a perk). > Even when I've been feeling really sore, the highest my sedrate has > been is > about 36. Sed rates of course, are only an indication of some sort of > inflammation, and are not specific to RA, but since I've seen many > people > who have sedrates in the 90's to 100's, I have developed great > sympathy. > If I " m having a flare at 36, people with those extremely elevated > levels, > need to be commended for being able to move at all. So my question > is, how > high have others sed rates been? Of course not everyone is nuts like > me, and > had blood drawn on a whim, but if you have results, I'm curious. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2004 Report Share Posted May 30, 2004 Hi Noreen...the lowest my sed rate has been in 24 years (that I know of) was 49, but they generally run from the 80's to 120's. I haven't had a sed rate since before my surgery in April. I'll be anxious to see what it is in June. I'm not in an RA remission any longer, and I started back on Humira 4 weeks ago now. The inflammation is moderate and I hope will lessen in time. Love & hugs... Tess Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2004 Report Share Posted May 30, 2004 What level of RA titer would be considered normal? --- a <paula54@...> wrote: > Noreen, > > Higher titers do tend to correlate with more severe > and sustained disease, > joint deformities and nodules according to studies. > Not all doctors seem to agree with this since they > have seen seronegative > patients have severe erosion. I am seronegative and > have what the doctors > consider severe erosion. Maybe in my case it is the > length of time that > I¹ve had the disease that correlates to the severity > of erosion. My sed > rates are always in the 40 to 50 range and before > Enbrel, it was always in > the 80¹s. > > > Rheumatoid Factor as a Diagnostic and Prognostic > Test > > Rheumatoid factor is a well-established diagnostic > and prognostic test in > RA. New studies support its usefulness in diagnosis; > it is included along > with the duration of symptoms, duration of morning > stiffness, arthritis in > three or more joint groups, metatarsophalangeal > tenderness, and anti-CCP > antibodies, in a scoring system developed to > differentiate persistent > arthritis from transient arthritis, and erosive > arthritis from persistent > nonerosive arthritis.[15] This scoring system was > shown to have better > discriminatory ability than the American College of > Rheumatology > classification criteria for RA. A study of the > performance of commercially > available ELISA test kits found large variation > among the kits in ability to > detect rheumatoid factor.[16] Antibodies to -enolase > and calpastatin have > been reported in patients with early RA, often in > the absence of rheumatoid > factor, but the low prevalence of these antibodies > in patients with RA makes > it unlikely that they will be useful as diagnostic > tests.[17, 18] > > Three recent prospective studies of patients with > early RA have confirmed > that rheumatoid factor is a major predictor of bone > damage as assessed by > radiographs.[19-21] Patients with a positive > rheumatoid factor were 2.5 > times more likely to have rapid progression of > Sharp/van der Heidje scores > over 1 year follow-up than those who were > seronegative for rheumatoid > factor.[19] In the Norfolk Arthritis Register Study, > patients with a > rheumatoid factor titer of greater than 1:160 > (latex) were 2.3 times more > likely to have worsening of their Larsen scores over > 5 years than those who > were seronegative.[20] Finally, patients with a > positive rheumatoid factor > were 3.3 times more likely to develop severe > radiographic damage over 12 > years than were those who were seronegative.[21] In > this latter study, > rheumatoid factor status was not associated with > functional disability or a > persistently active course of RA. Higher urinary > glucosyl-galactosyl-pyridinoline levels may also > predict more rapid > radiographic damage, but it is not clear if this is > independent of, or a > better predictor than, rheumatoid factor.[22] > > http://www.medscape.com/viewarticle/449856_2 > > a > > > > > > On 5/30/04 11:53 AM, " Noreen Saukko " > <nsaukko@...> wrote: > > > My RA titer was 86. I don't think though, that the > titer actually is an > > indication of the severity of the disease. Is that > correct and a? > > Since a person can have RA and be seronegative, > the actual number probably > > is not that significant. > > > > I'm a lab tech, and whenever I'm having a bad day, > I run a sed rate. (perks > > for working in the lab, if you consider getting > blood taken a perk). > > Even when I've been feeling really sore, the > highest my sedrate has been is > > about 36. Sed rates of course, are only an > indication of some sort of > > inflammation, and are not specific to RA, but > since I've seen many people > > who have sedrates in the 90's to 100's, I have > developed great sympathy. > > If I " m having a flare at 36, people with those > extremely elevated levels, > > need to be commended for being able to move at > all. So my question is, how > > high have others sed rates been? Of course not > everyone is nuts like me, and > > had blood drawn on a whim, but if you have > results, I'm curious. > > > > Noreen > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2004 Report Share Posted May 30, 2004 I mean what is the cut off between seronegative and positive? And is it posible for RA titer levels to fall once the disease is better controlled? --- a <paula54@...> wrote: > Noreen, > > Higher titers do tend to correlate with more severe > and sustained disease, > joint deformities and nodules according to studies. > Not all doctors seem to agree with this since they > have seen seronegative > patients have severe erosion. I am seronegative and > have what the doctors > consider severe erosion. Maybe in my case it is the > length of time that > I¹ve had the disease that correlates to the severity > of erosion. My sed > rates are always in the 40 to 50 range and before > Enbrel, it was always in > the 80¹s. > > > Rheumatoid Factor as a Diagnostic and Prognostic > Test > > Rheumatoid factor is a well-established diagnostic > and prognostic test in > RA. New studies support its usefulness in diagnosis; > it is included along > with the duration of symptoms, duration of morning > stiffness, arthritis in > three or more joint groups, metatarsophalangeal > tenderness, and anti-CCP > antibodies, in a scoring system developed to > differentiate persistent > arthritis from transient arthritis, and erosive > arthritis from persistent > nonerosive arthritis.[15] This scoring system was > shown to have better > discriminatory ability than the American College of > Rheumatology > classification criteria for RA. A study of the > performance of commercially > available ELISA test kits found large variation > among the kits in ability to > detect rheumatoid factor.[16] Antibodies to -enolase > and calpastatin have > been reported in patients with early RA, often in > the absence of rheumatoid > factor, but the low prevalence of these antibodies > in patients with RA makes > it unlikely that they will be useful as diagnostic > tests.[17, 18] > > Three recent prospective studies of patients with > early RA have confirmed > that rheumatoid factor is a major predictor of bone > damage as assessed by > radiographs.[19-21] Patients with a positive > rheumatoid factor were 2.5 > times more likely to have rapid progression of > Sharp/van der Heidje scores > over 1 year follow-up than those who were > seronegative for rheumatoid > factor.[19] In the Norfolk Arthritis Register Study, > patients with a > rheumatoid factor titer of greater than 1:160 > (latex) were 2.3 times more > likely to have worsening of their Larsen scores over > 5 years than those who > were seronegative.[20] Finally, patients with a > positive rheumatoid factor > were 3.3 times more likely to develop severe > radiographic damage over 12 > years than were those who were seronegative.[21] In > this latter study, > rheumatoid factor status was not associated with > functional disability or a > persistently active course of RA. Higher urinary > glucosyl-galactosyl-pyridinoline levels may also > predict more rapid > radiographic damage, but it is not clear if this is > independent of, or a > better predictor than, rheumatoid factor.[22] > > http://www.medscape.com/viewarticle/449856_2 > > a > > > > > > On 5/30/04 11:53 AM, " Noreen Saukko " > <nsaukko@...> wrote: > > > My RA titer was 86. I don't think though, that the > titer actually is an > > indication of the severity of the disease. Is that > correct and a? > > Since a person can have RA and be seronegative, > the actual number probably > > is not that significant. > > > > I'm a lab tech, and whenever I'm having a bad day, > I run a sed rate. (perks > > for working in the lab, if you consider getting > blood taken a perk). > > Even when I've been feeling really sore, the > highest my sedrate has been is > > about 36. Sed rates of course, are only an > indication of some sort of > > inflammation, and are not specific to RA, but > since I've seen many people > > who have sedrates in the 90's to 100's, I have > developed great sympathy. > > If I " m having a flare at 36, people with those > extremely elevated levels, > > need to be commended for being able to move at > all. So my question is, how > > high have others sed rates been? Of course not > everyone is nuts like me, and > > had blood drawn on a whim, but if you have > results, I'm curious. > > > > Noreen > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2004 Report Share Posted May 31, 2004 , High titers usually are diagnostic, but titers of 1:20 to 1:80 are in grey zone. Yes, with successful treatment the RF can drop. http://www.wheelessonline.com/oo3/122.htm a On 5/30/04 10:07 PM, " Bullock " <bullockpe@...> wrote: > I mean what is the cut off between seronegative and > positive? And is it posible for RA titer levels to > fall once the disease is better controlled? > --- a <paula54@...> wrote: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2004 Report Share Posted May 31, 2004 , ideally one would like the RF titer or number of units to be 0. Unfortunately, since not every lab uses the very same test, there is no standard cutoff between " normal " (which can be greater than zero) and positive. You'll notice that the values are given in different units and measured by various methods depending on the lab. Values can be reported as, for example, 1:X, or X U/ml or X IU/ml or even X AU/ml. The lack of a standard is a HUGE problem. Yes, the values can fall with treatment, but, normally, once the diagnosis is certain, repeated measurements of the RF need not be done (and usually aren't). With respect to reflecting disease activity, it doesn't tell you more than sed rate or CRP. Physicians and researchers have been arguing about whether there is a correlation between fluctuating levels and disease activity, but there is no consensus. There is also no agreement whether RF is destructive or helpful. Finally, even if the RF is a high positive, although it can lend support to an RA diagnosis, another disease process can be responsible. That's why they're investigating tests that are more sensitive for and specific to RA (like anti-CCP). I'll tell you where to go! Mayo Clinic in Rochester http://www.mayoclinic.org/rochester s Hopkins Medicine http://www.hopkinsmedicine.org Re: [ ] RA titer > I mean what is the cut off between seronegative and > positive? And is it posible for RA titer levels to > fall once the disease is better controlled? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2004 Report Share Posted May 31, 2004 All I can say Tess is Ouch. Glad you are back and posting. You must be feeling stronger Noreen Re: [ ] RA titer Hi Noreen...the lowest my sed rate has been in 24 years (that I know of) was 49, but they generally run from the 80's to 120's. I haven't had a sed rate since before my surgery in April. I'll be anxious to see what it is in June. I'm not in an RA remission any longer, and I started back on Humira 4 weeks ago now. The inflammation is moderate and I hope will lessen in time. Love & hugs... Tess Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 7, 2007 Report Share Posted November 7, 2007 Thank you everyone for all your information and imput. I have a few things further to check out now. Thanks again Sara Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 7, 2007 Report Share Posted November 7, 2007 you're very welcome, thats what our support forum is about!sunbeltcity <Sonage@...> wrote: Thank you everyone for all your information and imput. I have a few things further to check out now.Thanks againSaraJackie Quote Link to comment Share on other sites More sharing options...
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