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The Role of the Laboratory in the Diagnosis of Rheumatoid Arthritis



Laboratory Evaluation of Patient with RA

Slide 7

August 2011

To expand a little on the laboratory evaluation of a patient with rheumatoid arthritis , testing usually begins with a general assessment of the patient. This almost always includes a CBC with differential to determine if the patient has any cytopenias or elevated cell counts. Inflammatory markers are also often assessed to determine if the patient has evidence of an inflammatory process. Liver and renal function may also be evaluated. This is not usually for diagnostic purposes, but to help guide potential therapeutic interventions. Total immunoglobulins may also be evaluated. Patients with rheumatoid arthritis may have elevated total immunoglobulins, and a protein electrophoresis may be needed to rule out a possible monoclonal gammopathy.

The serology testing most useful for rheumatoid arthritis are rheumatoid factor and anti-CCP antibodies. These are not only useful diagnostically, but also prognostically, as high titers of antibodies may identify a patient at risk for more severe disease.

In addition, a clinician may want to perform a synovial fluid analysis. Although the results of this analysis may not be diagnostic for rheumatoid arthritis, it can be useful to rule out an infection or a crystalline arthritis.

At this point, I would like to expand on the serology testing for rheumatoid factor and anti-CCP antibodies.

Laboratory Evaluation of Patient with RA

 


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