Rheumatoid Arthritis

If you suspect you have rheumatoid arthritis, then you need to read this guide to rheumatoid arthritis blood test benefits, types, treatment options, and get tested.

The rheumatoid arthritis blood test can provide an accurate reading of your blood levels of Rheumatoid factor and antinuclear antibodies, often present in persons with rheumatic disease. Order from Ulta Lab Tests today, with confidential results available in 24 to 48 hours online.       

In the guide below the list of tests, we explain and answer your questions on Rheumatoid Arthritis tests.


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Ulta - Arthritis & Inflammation Deep Dive

This panel is a cure for WYSIATI – what-you-see-is-all-there-is. If all we do is measure a simple inflammation test, like the CRP, it is easy to fall into a trap of assuming inflammation is “arthritis”. But what if there is an infection or what if there is another reason for the pain or inflammation-like symptoms? Could it be a nutrient deficiency or excess? Could it be lack of recovery or abnormal stress hormone? This panel offers a remarkably deep dig into possible causes of inflammation, well beyond the typical tests ordered in practice. Sometimes our first impression is not the true answer. Results should be reviewed with you by a licensed healthcare provider.

  • ANA Screen, IFA with Reflex to Titer and Pattern, IFA #249
  • C-Reactive Protein (CRP) #4420
  • CBC (includes Differential and Platelets) #6399
  • Comprehensive Metabolic Panel (CMP) #10231
  • Cyclic Citrullinated Peptide (CCP) Antibody (IgG) #11173
  • Lipid Panel with Ratios #19543
  • Rheumatoid Factor #4418
  • Sed Rate by Modified Westergren (ESR) #809
  • Lyme Disease Antibodies (IgG, IgM), Immunoblot #8593
  • Cortisol, A.M. #4212
  • Creatine Kinase (CK), Total #374
  • DHEA Sulfate, Immunoassay #402
  • Ferritin #457
  • Hemoglobin A1c (HgbA1C) #496
  • Insulin #561
  • Testosterone, Free (Dialysis) and Total MS #36170
  • TSH #899
  • Vitamin B12 (Cobalamin) #927
  • Vitamin D, 25-Hydroxy, Total, Immunoassay #17306

Clinical Significance

Rheumatoid Arthritis Diagnostic IdentRA® Panel 2 - Early diagnosis of rheumatoid arthritis (RA), ie, diagnosis before significant joint erosion occurs, is difficult. Psoriatic arthritis can also be difficult to diagnose clinically early in the disease process, and there are no specific biomarkers. The 14-3-3η (eta) protein is an emerging biomarker for RA and erosive psoriatic arthritis diagnosis. It may play a biologic role in the joint erosive process. Blood levels appear to be elevated in patients with RA, but not in other diseases including psoriasis, osteoporosis, gout, ulcerative colitis, type 1 diabetes, systemic lupus erythematosus, Crohn disease, primary Sjögren syndrome, scleroderma, and multiple sclerosis. The 14-3-3η protein, used in conjunction with rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibody, may improve diagnostic sensitivity in the early diagnosis of RA. It may also help differentiate those with psoriatic arthritis joint damage from those without joint damage.


Antinuclear antibodies are associated with rheumatic diseases including Systemic Lupus Erythematous (SLE), mixed connective tissue disease, Sjogren's syndrome, scleroderma, polymyositis, CREST syndrome, and neurologic SLE. 

Reflex Information: If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge.


ANAlyzeR™ ANA, IFA with Reflex Titer/Pattern, Systemic Autoimmune Panel 1

Includes

  • ANA Screen,IFA, with Reflex to Titer and Pattern
  • DNA (ds) Antibody, Crithidia IFA with Reflex to Titer
  • Chromatin (Nucleosomal) Antibody
  • Sm Antibody
  • Sm/RNP Antibody
  • RNP Antibody
  • Sjogren's Antibodies (SS-A, SS-B)
  • Scleroderma Antibody (Scl-70)
  • Jo-1 Antibody
  • Centromere B Antibody
  • Complement Component C3c and C4c
  • Cardiolipin Antibodies (IgA, IgG, IgM)
  • Beta-2-Glycoprotein I Antibodies (IgG, IgA, IgM)
  • Rheumatoid Factor (IgA, IgG, IgM)
  • Cyclic Citrullinated Peptide (CCP) Antibody (IgG)
  • 14.3.3 eta Protein
  • Thyroid Peroxidase Antibodies (TPO)

 

  • If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge (CPT code(s): 86039).
  • If the DNA (ds) Antibody Screen is positive, then DNA (ds) Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

 

Alternative Name(s)

Expanded ANA Antibodies,Systemic Autoimmune Disorder,ANA and Expanded AI Testing,ANA and Systemic Autoimmunity,Comprehensive AI Testing,Early Systemic Autoimmune Disease,Autoimmune Disorders


Rheumatoid Factor (IgA, IgG, IgM) 

Reference Range(s)

  • Rhematoid Factor (IgA)
    • ≤6 Negative
    • >6 Positive
  • Rhematoid Factor (IgG)
    • ≤6 Negative
    • >6 Positive
  • Rhematoid Factor (IgM)
    • ≤6 Negative
    • >6 Positive

Rheumatoid factor is commonly used as a blood test for the diagnosis of rheumatoid arthritis. However, rheumatoid factor can also be present in individuals with other conditions such as lupus, infectious hepatitis, syphilis, mononucleosis, tuberculosis, liver disease, and sarcoidosis. Rheumatoid factor is an antibody that is detectable in the blood of 80% of adults with rheumatoid arthritis. Rheumatoid can be detected in the blood of normal individuals and of those with other autoimmune diseases that are not rheumatoid arthritis. In people with rheumatoid arthritis, high levels of rheumatoid factor can indicate a tendency toward more aggressive disease and/or a tendency to develop rheumatoid nodules and rheumatoid lung disease. Rheumatoid factor is actually an antibody that can bind to other antibodies. Antibodies are normal proteins in our blood that are important parts of our immune system. Rheumatoid factor is an antibody that is not usually present in the normal individual. Rheumatoid factor is commonly used as a blood test for the diagnosis of rheumatoid arthritis. Rheumatoid factor is present in about 80% of adults (but a much lower proportion of children) with rheumatoid arthritis.

Rheumatoid factor is commonly used as a blood test for the diagnosis of rheumatoid arthritis. However, rheumatoid factor can also be present in individuals with other conditions such as lupus, infectious hepatitis, syphilis, mononucleosis, tuberculosis, liver disease, and sarcoidosis. Rheumatoid factor is an antibody that is detectable in the blood of 80% of adults with rheumatoid arthritis. Rheumatoid can be detected in the blood of normal individuals and of those with other autoimmune diseases that are not rheumatoid arthritis. In people with rheumatoid arthritis, high levels of rheumatoid factor can indicate a tendency toward more aggressive disease and/or a tendency to develop rheumatoid nodules and rheumatoid lung disease. Rheumatoid factor is actually an antibody that can bind to other antibodies. Antibodies are normal proteins in our blood that are important parts of our immune system. Rheumatoid factor is an antibody that is not usually present in the normal individual. Rheumatoid factor is commonly used as a blood test for the diagnosis of rheumatoid arthritis. Rheumatoid factor is present in about 80% of adults (but a much lower proportion of children) with rheumatoid arthritis.

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Elevated RF is found in collagen vascular diseases such as SLE, rheumatoid arthritis, scleroderma, Sjögren's Syndrome, and in other conditions such as leprosy, tuberculosis, syphilis, malignancy, thyroid disease and in a significant percentage of otherwise normal elderly patients.

Increased CRP levels are found in inflammatory conditions including: bacterial infection, rheumatic fever, active arthritis, myocardial infarction, malignancies and in the post-operative state. This test cannot detect the relatively small elevations of CRP that are associated with increased cardiovascular risk.

Useful in differentiating inflammatory and neoplastic diseases and as an index of disease severity. CRP is also useful in monitoring inflammatory disease states.

A synthetic circular peptide containing citrulline called CCP IgG (cyclic citrullinated peptide) has been found to be better at discriminating Rheumatoid Arthritis patients from other patients than either the perinuclear autoantibody test or the test for rheumatoid factor. Approximately 70% of patients with Rheumatoid Arthritis are positive for Anti-CCP IgG, while only about 2% of random blood donors and disease controls subjects are positive.

A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia, and inflammatory processes.

A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

NOTE: Only measurable biomarkers will be reported.

Reflex Parameters for Manual Slide Review
  Less than  Greater Than 
WBC  1.5 x 10^3  30.0 x 10^3 
Hemoglobin  7.0 g/dL  19.0 g/dL 
Hematocrit  None  75%
Platelet  100 x 10^3  800 x 10^3 
MCV  70 fL  115 fL 
MCH  22 pg  37 pg 
MCHC  29 g/dL  36.5 g/dL 
RBC  None  8.00 x 10^6 
RDW  None  21.5
Relative Neutrophil %  1% or ABNC <500  None 
Relative Lymphocyte %  1% 70%
Relative Monocyte %  None  25%
Eosinophil  None  35%
Basophil  None  3.50%
     
Platelet  <75 with no flags,
>100 and <130 with platelet clump flag present,
>1000 
Instrument Flags Variant lymphs, blasts,
immature neutrophils,  nRBC’s, abnormal platelets,
giant platelets, potential interference
     
The automated differential averages 6000+ cells. If none of the above parameters are met, the results are released without manual review.
CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

  • Confirmation of differential percentages
  • WBC and platelet estimates, when needed
  • Full review of RBC morphology
  • Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
  • significant findings
  • If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

  • Immature, abnormal, or toxic cells
  • nRBC’s
  • Disagreement with automated differential
  • Atypical/abnormal RBC morphology
  • Any RBC inclusions

Step 3 If any of the following are seen on the manual differential, a Pathologist will review the slide:

  • WBC<1,500 with abnormal cells noted
  • Blasts/immature cells, hairy cell lymphs, or megakaryocytes
  • New abnormal lymphocytes or monocytes
  • Variant or atypical lymphs >15%
  • Blood parasites
  • RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
  • crystals, Pappenheimer bodies or bizarre morphology
  • nRBC’s

Comprehensive Metabolic Panel



Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly Systemic Lupus Erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis, and primary Sjögren's syndrome.

Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly Systemic Lupus Erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis, and primary Sjögren's syndrome.

Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly Systemic Lupus Erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis and primary Sjögren's syndrome.

Decreased C3 and C4 levels may be associated with acute glomerulonephritis, membranoproliferative glomerulonephritis, immune complex disease, active systemic lupus erythematosis, cryoglobulinemia, congenital C4 deficiency and generalized autoimmune disease

Decreased C4 level is associated with acute systemic lupus erythematosis, glomerulonephritis, immune complex disease, cryoglobulinemia, congenital C4 deficiency and generalized autoimmune disease

CH50 is a screening test for total complement activity. Levels of complement may be depressed in genetic deficiency, liver disease, chronic glomerulonephritis, rheumatoid arthritis, hemolytic anemias, graft rejection, systemic lupus erythematosis, acute glomerulonephritis, subacute bacterial endocarditis and cryoglobulinemia. Elevated complement may be found in acute inflammatory conditions, leukemia, Hodgkin's Disease, sarcoma, and Behcet's Disease.

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Cortisol is increased in Cushing's Disease and decreased in Addison's Disease (adrenal insufficiency). Patient needs to have the specimen collected between 7 a.m.-9 a.m.



There are approximately 1.3 million sufferers of rheumatoid arthritis across the United States. Interestingly, the condition is 2.5 times more likely to impact women than men. 

While you might imagine the term arthritis with someone who is aging, it's also interesting to note that it's most common to get a rheumatoid arthritis diagnosis between the ages of 20 and 50. 

So, how do people with rheumatoid arthritis know they have it? What are the signs they experience that tell them they should be tested? Is a rheumatoid arthritis blood test the best way to find out if you suffer from this?

Read on to learn everything you need to know about people with RA and getting tested if you think you might have it.

What Is Rheumatoid Arthritis?

You might associate the term arthritis with aches, pains, and maybe some swelling. There are a few ways this type of arthritis is unique from other forms. 

Rheumatoid arthritis causes swelling in the joints, which isn't uncommon with arthritis. However, with rheumatoid arthritis, the swelling is symmetrical. You won't feel it just in your left hand. Instead, it's highly likely that you will get swelling in both hands.

The other way that rheumatoid arthritis is different is that it's classified as an autoimmune disease. While regular arthritis may cause wear and tear in the joints, RA develops and impacts those afflicted through the immune system. 

Understanding the Impact of Rheumatoid Arthritis

Rheumatoid arthritis impacts the joints in the body by causing swelling inside the lining of the joints. The swelling, if not treated, can cause bone erosion and joint deformity.

Another difference between wear and tear arthritis and rheumatoid arthritis is that RA can have an impact beyond the joints.  RA can impact other body systems including the skin, eyes, lungs, heart, and blood vessels, in severe cases. 

An RA sufferer who is early in the disease will often feel the impact in their smaller joints first. This might include their fingers, wrists, and hands. As the disease progresses or gets more severe, it will spread to larger joints and other parts of the body. 

Risks Factors Associated With Rheumatoid Arthritis

So, what can trigger the disease for you? There are some associated risk factors that come with rheumatoid arthritis.  

Females are more likely to get the disease than males. If someone in your family has rheumatoid arthritis, you have a higher likelihood of also having the disease. 

Smoking is another risk factor for the disease. It seems that if you're a smoker and have a family history, your chances are increased that you'll get RA. Smokers with RA also seem to have symptoms that are more severe. 

Causes of Rheumatoid Arthritis

In a healthy body, the immune system helps to fight off disease and infection. Remember that rheumatoid arthritis is an autoimmune disease. What happens with rheumatoid arthritis is that the immune system actually attacks the healthy tissues inside your joints. 

Scientists are unclear what causes your immune system to start this attack. There are some factors that seem to contribute to the likelihood of getting RA. There doesn't seem to be a direct genetic connection. Although if a person is exposed to certain environmental factors like an infection from certain bacteria or a virus, it can trigger the disease. 

There does seem to be a correlation between stress and the onset of RA too. 

Signs and Symptoms of Rheumatoid Arthritis

For those suffering from rheumatoid arthritis, you might find that you can get yourself into remission. In this case, your symptoms decrease, and you don't feel the impact of the disease. It doesn't mean it has gone away; it is just more dormant. Often those suffering from rheumatoid arthritis have no symptoms when in remission.

If you're having a flare-up, your symptoms come back and are exacerbated. Symptoms might include:

  • Joint pain
  • Joint swelling
  • Joint stiffness
  • Loss of joint function and deformities

Symptoms for those not in remission can also come and go. The severity of the symptoms can also vary. It's important not to ignore the symptoms when they flare-up, even if they seem mild. You want to keep them under control, so they don't get worse.

Testing for Rheumatoid Arthritis

Getting an RA diagnosis can take some time. It's likely your doctor will do a physical exam and look closely at your joints. If your doctor suspects you might be suffering from RA, you should have blood tests done. It's pretty common to continue to monitor with regular blood tests once you have an RA diagnosis.

Blood tests will look for the rheumatoid factor or RF antibody. The RF antibodies will line the tissue of your joints and are present for many people who suffer from RA. RF is not exclusive to rheumatoid arthritis but is often present. 

Some of the RF blood tests include:

Blood tests will also look for:

Testing for RA panels include:

Once there is an RF antibody located, doctors will also look for these other indicators. The RF antibody is called immunoglobulin IgM.

Answering Your Questions About Rheumatoid Arthritis and Getting Tested for It 

Let's answer some common questions related to rheumatoid arthritis. 

What early signs should you watch for in rheumatoid arthritis? Early signs of RA usually include swelling in the joints that causes pain and swelling. 

When will sufferers feel the most impact of the disease? It's likely that RA will impact sufferers more in the morning than at other times in the day.

What does a rheumatologist do? A rheumatologist studies rheumatology which includes:

  • Joints
  • Muscles
  • Bones
  • Autoimmune diseases
  • Soft tissue diseases

It's likely your family doctor will refer you to a rheumatologist for further treatment and diagnosis if you believe you're suffering from RA.

Benefits of Rheumatoid Arthritis Blood Test With Ulta Lab Tests 

Ulta Lab Tests offers our tests to be highly accurate and reliable so you can make informed decisions about your health.
• Secure and confidential results
• No insurance referral is needed
• Affordable pricing 
• 100% satisfaction guarantee

Order your rheumatoid arthritis lab test today and your results will be provided to you securely and confidentially online in 24 to 48 hours for most tests.

Take Control of Your Symptoms and Get Tested Today for Rheumatoid Arthritis

Rheumatoid arthritis blood tests can help you get the answers you need. The sooner you can understand if you have RA, the sooner you can work to get control of it too. 

Take charge of your health and track your progress with Ulta Lab Tests.