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PLEASE NOTE THIS TEST IS BEING DISCONTINUED AT THE END OF APRIL

Rheumatoid Arthtitis

Rheumatoid Arthritis (RA) is a common autoimmune disease and is characterised by the inflammation of the joints causing pain, swelling and stiffness. Whilst it is more common in women over 40 years of age, it can affect anyone at any age, including children. The exact causes of Rheumatoid Arthritis are still unknown but the disease can be triggered by general illnesses and severe emotional or physical trauma in individuals with a genetic predisposition to the disease. It usually first noticed in peripheral joints such as the fingers, wrists and ankles, but can affect any joint.

Symptoms
The symptoms of rheumatoid arthritis often tend to come and go and you will experience what are known as 'flare ups'. This means that from time to time, your condition will worsen and your symptoms will be more intense and severe. You can experience a flare-up at any time of the day or night. However, it is likely that your symptoms will be more painful in the morning, when you first wake up. Usually, your symptoms will begin to ease as the day progresses, as you start using and flexing your joints.

Once rheumatoid arthritis progresses, it can spread to other joints, such as your shoulders, elbows, hips and jaw. The condition tends to affect several joints at the same time, usually on both sides of your body. For example, it often affects both knees or both hands.

  • Joint pain and swelling - this is usually worst in the morning and tends to improve as you move around.
  • Joint stiffness - again, this often improves once you start moving around.
  • Warmth and redness - the lining of the affected joint becomes inflamed, leaving the skin over the joint warm, red and swollen.
  • Loss of appetite.
  • Generally feeling unwell.
  • Skin nodules - one in four people with rheumatoid arthritis develop lumps under their skin, known as rheumatoid nodules. These commonly occur on the skin over the elbows and forearms, and are usually painless.
  • Anaemia - this is a condition where the blood is unable to carry enough oxygen, due to a low number of red blood cells. It often leaves you feeling tired and lethargic. Eight out of ten people with rheumatoid arthritis are anaemic. ( please insert Anaemia test hyperlink)

Why Test for Rheumatoid Arthritis?
The availability of sophisticated therapies and anti-rheumatic drugs that dramatically reduce  disease progression make early diagnosis and treatment essential to avoid long-term damage to joints.

How do the tests work?

1. Citrullinated protein antibody (CPA) test
This test detects Citrullinated Protein Antibodies (CPA) which have been recently shown to be highly specific for RA.  The antigens recognised by these antibodies contain a modified form of arginine, termed citrulline. Citrullination has been shown to be an essential step in generating RA-specific antibodies in susceptible individuals, perhaps via a breakdown in immune tolerance to self-antigens.  Importantly, CPA can be detected both in early and fully developed RA and are even present in some patients several years prior to the onset of disease.  The ability to accurately diagnose RA in the early stages of the disease, or even before disease onset, obviously allows for earlier treatment and the opportunity to delay disease progression.

2. Rheumatoid factor IgM and IgA test
This test detects Rheumatoid Factors (RFs) which are autoantibodies directed against the Fc region of human IgG.  Elevated RFs are found in 70-90% of patients with rheumatoid arthritis (RA) but also occur frequently in patients with other rheumatic as well as infectious and pulmonary diseases. IgM RFs are considered a risk factor in normal subjects.

IgA RFs are reportedly associated with bone erosions and symptoms originating from mucosal membranes and secretory organs.  A number of studies indicate that the IgA RFs in early disease indicate poor prognosis and justify a more aggressive course of treatment.  Elevation in IgA RFs may precede the increase in IgM RF titre.

Treatment
There is no cure for RA, however, if your results are positive you should discuss them with your GP who can, if necessary, prescribe drugs or therapies that can be successful in:

  • Reducing inflammation, pain, and stiffness in affected joints.
  • Preventing or limiting the amount of joint damage.

Sample requirements & test turnaround
A pin-prick blood sample is required. Results are available within 10 working days.