Re: New to group - response to RA factor and Sed rate

[Guest guest]

Yes, it's really frustrating, Abby. The tests are not always very

helpful. Sorry about that.

How old are you and how long has this been going on? Any family history?

Which joints are at times swollen?

You could ask your rheumatologist if she'll run an anti-CCP test if it's

available.

********************

Ann Rheum Dis. 2003 May;62(5):427-30.

Autoantibodies can be prognostic markers of an erosive disease in early

rheumatoid arthritis.

Vencovsky J, Machacek S, Sedova L, Kafkova J, Gatterova J, Pesakova V,

Ruzickova S.

Institute of Rheumatology, Prague, Czech Republic. venc@...

OBJECTIVE: To evaluate a contribution of selected laboratory parameters

for a prediction of progressive and erosive development in patients with

early rheumatoid arthritis (RA). METHODS: In a prospective study

baseline levels of antibodies to cyclic citrullinated peptide

(anti-CCP), IgM, IgA, and IgG rheumatoid factors (RFs) were measured by

enzyme linked immunosorbent assay (ELISA) in 104 patients with RA with

disease duration <2 years. Antikeratin antibodies (AKA) and

antiperinuclear factor (APF) were detected by indirect

immunofluorescence. Patients were divided into two groups based either

on the presence or absence of erosions or according to progression of

Larsen score at the end of the 24 months' follow up. RESULTS: Sixty

seven (64%) patients developed radiographic erosions, 49 (47%) had

progression in Larsen score, and 36 (35%) progressed by more than 10

Larsen units. Significant differences in erosions and progression

between the two groups were detected for anti-CCP, AKA, APF, IgM RF, IgA

RF, and IgG RF. Baseline Larsen score correlated significantly with

anti-CCP, IgM RF, and IgA RF levels, and all measured antibodies

correlated with the progression >10 units. The combination of anti-CCP

and IgM RF increased the ability to predict erosive and progressive

disease. CONCLUSION: The data confirmed that measurement of anti-CCP,

AKA, APF, and individual isotypes of RFs was useful for prediction of

structural damage early in the disease course. Combined analysis of

anti-CCP and IgM RF provides the most accurate prediction.

PMID: 12695154

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

2695154 & dopt=Abstract

********************

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] New to group - response to RA factor and Sed rate

> Hi all,

> I'm new and was reading about the lab values with interest. I am in

the

> medical field as well.

> I have had all the symptoms of RA and have the diagnosis of

inflammatory

> arthritis at this point with probable RA. symmetrical joint pain in

multiple

> sites, morning stiffness, fatigue, weight loss, fever, etc. etc. for a

very long

> time. I finally went and saw a rheumatologist because NSAIDs and

everything

> else I tried, including my rationalizations didn't help.

>

> She started me on Plaquenil, drew labs, and after about a week or so

of the

> Plaquenil, I broke out in hives. I stopped it. I went in today. My

labs are

> normal. Sed rate normal. RF- normal. ANA mildly positive at only 1:40.

CRP

> negative. Surprisingly my hand xrays were " concerning " as they showed

some

> periarticular changes with mild osteopenia (thinning)/erosion at the

MCPs. She told me

> I should take some calcium. Asked me what I thought we should do.

Ummm.....

> I'm a little stumped. I know that my joints do get red and hot and

very

> swollen..even though they weren't right then this morning. It seems to

vary day to

> day. Is that normal?

>

> I ended up leaving with Prednisone 5mg daily and Sulfasalzine.

>

> I guess my comments really are about my frustration with the

diagnostic

> process here. Whether this is RA of not.. what is it? I was reading

publications

> from the arthritis foundation and they said that only 60% of RA

patients have

> elevated sed rates and CRPs........and that people can have normal sed

> rates/crps... and RF's. After I read that I was glad we decided to

treat me.... but at

> the same time, how frustrating is that???

>

>

> Abby

[Guest guest]

Hi Abby,

Welcome to the group! Another member of the " frustration

foundation! " I don't have RA, but do have FM, Dercum's disease, and

who knows what other autoimmune bugs simmering. It is indeed a

frustration process trying to find out exactly what we have, get it

properly diagnosed and treat it, isn't it? All my labs are normal,

except when I go into a " Dercum flare " and then my SED rate jumps

slightly, which is due to the angiolipomas growing--they multiply

like oversexed bunnies sometimes.

I hope you find the answers you need, this is a very good group for

information, support, and comfort. And I really love your screen

name! I think coffee should be added to the list of food groups. My

only great regret about living in this small town in Indiana is there

is no Starbucks here!

Judi

[Guest guest]

In a message dated 7/13/2004 10:14:25 PM Pacific Daylight Time,

Matsumura_Clan@... writes:

CONCLUSION: The data confirmed that measurement of anti-CCP,

AKA, APF, and individual isotypes of RFs was useful for prediction of

structural damage early in the disease course. Combined analysis of

anti-CCP and IgM RF provides the most accurate prediction.

Hi and thanks for the welcome.

I can't be quoted but I think she may have done this test and it was ok...

but I'm not sure. But I read the above conclusion and see that it is " useful " in

the prediction. I see that this is a disease that is not clearly defined...

no wonder it's frustrating. No wonder there are so many types of arthritis and

inflammatory arthritis. My doctor thinks I might have a couple of types as

well.

I actually feel better today on the prednisone. Funny thing is when I took

the three days of 20 mg of prednisone for the plaquenil rash, I didn't. I

suspect now it was because I felt so lousy from the rash and from the drug

itself.... but now after only 2 days of the 5 mg dose, my feet and hands don't

hurt

like they did and my knees feel so much better it's amazing! What does that say!

I'm WEIRD!!!

I'm 38 years old. This has been going on since before 10/03. At first I

thought it must have been neurological due to the fatigue and numbness and

tingling

in my hands primarily (though maybe it was carpal tunnel.... then neck

related- all tests, MRI- emgs negative) and then it moved into my toes.

Eventually

the pain moved into my ankles and then bilateral joints. It was always

symmetrical....... and then my elbows and affected my sleep. Very uncomfortable.

It

hurt to roll over, hurts to bump into things, etc. The joints get swollen, red

and enlarged.... but not today.

I'm a freak of nature I think.

Abby