Rheumatoid factor test results

Elmbow

Hello. I just have a quick query. I am not diagnosed with RA but I think I have signs of it. My rheumatoid factor test results was expressed as:

20 iu/mL <

The normal range given was < 20 iu/mL. I do not understand my result, with the < symbol after the number. Does my result "20 iu/mL <" mean it was less than 20? Or 20?

Any help appreciated, thank you.

[Deleted User]

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stickywicket

Hello Elmbow and welcome from me, too

I'm afraid I've no idea what your figures mean. We are not medically qualified on here just very unenthusiastic and reluctant amateurs I suggest you ask your GP, or whoever ordered the test, to interpret for you. My own best guess would be that it meant less than 20 but that is pure guesswork from one who merely scraped through O-level maths.

dreamdaisy

I have a form of auto-immune arthritis which is sero-negative, i.e. no rheumatoid factor is present. Blood tests tell us only so much, and unless we are fluent in medic the much that they tell us isn't much. I reckon it's best to contact the medico who ordered the test for an explanation. I wish you well (and sincerely hope you are not affected by any version of this dross). DD

Elmbow

Thank you all.

I don't have a diagnosis so I can't possibly assume to understand what those of you who do are going through. But I know something is wrong and it's really frustrating when the blood tests say there isn't.

A little support is just what the doctor ordered (or didn't!)

stickywicket

Does the blood test say not? Did you finally determine that? As DD says, the bloods don't tell the full story. Have you been referred to a rheumatologist?

Elmbow

No, I haven't been referred. My doctor thinks I have a problem with my neck. I don't know why. I never mentioned my neck. I complained of pain and swelling in the joints of my hands, wrists, and big toes; numbness in my hands and prolonged morning stiffness. He didn't even examine my hands. Or neck. He wasn't dismissive, he just seemed to focus on the wrong thing.

He sent me for some blood tests anyway, including RF, CRP and ESR, to rule out some things. All they showed was slight anemia. He said everything else was okay. The RF seems to be "less than 20". My CRP was 4.

Ironically, I developed some neck pain AFTER seeing the doctor.

Although I am not 100% convinced I have RA (how could I be), I'm not convinced it can be ruled out yet either. But my doctor seems to have done just that.

dreamdaisy

There are around 300 kinds of auto-immune-arthritis-related conditions so diagnosis is not necessarily a straightforward procedure. GPs know a little about a lot but your bloods don't seem to be telling the right story for an auto-immune arthritis which could be why he hasn't referred you. What other symptoms apart from the joint pain and swelling are you experiencing? DD

stickywicket

I'm no doc but I'd guess that the reason why yours feels you have a neck problem is because of the numbness. In all my years of RA I've never experienced it. Mine started in my fingers, moved to ankles and shoulders and then spread. When people on these forums talk of numbness it's usually because of nerve problems, possibly caused by osteoarthritis.

Docs don't do much hands-on stuff now because they can tell more from the tests. Unfortunately, auto-immune forms of arthritis can be sneaky little beasts that bunk off for tests. Has anyone in your family got / had any auto-immune diseases (not just arthritis but others such as Type 1 diabetes, coeliac disease, asthma etc)? There's often a genetic component.

I'd guess that your GP isn't just dismissing you but is trying to work from basics. The tests he did are good first tests but don't tell the full story. Go back, but meanwhile keep a diary of symptoms, when and where, if caused by anything obvious etc and take pictures of any swelling. And let's know how you get on.

frogmorton

My bloods are always negative too, but I was able to show the doctor the swelling I had at the time so got referred to a rheumatologist from there.

I suggest you keep on going back and in the meantime gather evidence. I take photos sometimes to my appointments as I am very often super-well when they come around :roll:

Stickywicket's diary suggestion is a very good idea, include any odd symptoms which might appear unconnected such as a raised temperature or rash.

Best of luck

Toni x

Elmbow

Thanks for all your advice - and for listening.

Dreamdaisy, my symptoms are mainly the fingers/wrists joint pain, all-over stiffness and hand numbness. The MCP joints in my index fingers are the most painful, red and hot. A few joints in my fingers have sort of "bulged" permanently. Without boring you with the details, the pain and stiffness is enough that it's having an impact on my normal life and work.

I have this week developed a hard swelling on the back of one hand. It feels (and looks) like the bones are trying to poke through the skin. I have no idea if this is relevant.

I generally feel a bit off, though I am slightly anaemic so would expect low energy.

Also possibly relevant, possibly not; I was misdiagnosed with gout about eight months ago (shortly before the other symptoms started) by a locum GP. The pain is now at the base of both big toes and one has developed a bunion. The locum observed swelling and warmth in the joint at the time. My GP now says it wasn't gout as my blood tests at the time were fine. Which makes me wonder: what is it?

Stickywicket: Yes, my doctor is definitely focusing on the numbness. Understandable, and perhaps I do have a problem with my neck, but I don't see how that explains everything. I suppose I have to weigh up what little I know from reading, against his years of training and experience.
There are several autoimmune diseases in my wider family, including lupus, pernicious anaemia (my B12 was tested and is okay) and rheumatoid arthritis.

I am currently waiting for feedback from neck x-ray and will take it from there. I'm 36 and female, by the way, in case you want to put this into some context.

dreamdaisy

Is your GP aware that there are auto-immune issues within your family? If so then I am very surprised that you haven't been referred to a rheumatologist (unlike GPs they know a lot about a little). Mind you, the first rheumatologist I saw dismissed me out of hand despite an enormously swollen and hot-to-the-touch left knee - I've proved him wrong!

My mother's side of the family donated my eczema and asthma, my father's psoriasis. Neither of my parents were affected by these conditions whereas I am and they have certainly affected my life; it's never been as it could have been. Ho-hum. DD

Elmbow

Hi. No, I mentioned the familial pernicious anaemia but only after my GP mentioned that my blood test results were potentially consistent with a vitamin B12 deficiency (slight anaemia and enlarged red blood cells).

stickywicket

It is important to let the docs (GP or rheumatologist) know of the family history of auto-immune diseases.

It's possible that the neck x-ray will show some OA which could account for the numbness. The problem is that that doesn't necessarily mean that's all you have :roll:

There are several sero-negative forms of auto-immune arthritis, known collectively as spondyloarthropathies. This might explain it all better than I can. http://tinyurl.com/p9nyzpp If you feel any of it is relevant to you then maybe print that bit off to show your GP. GPs are not experts in rheumatology (That's why we have rheumatologists) but good ones are always happy to learn. Unfortunately they are also beseiged by patients who think a spot of googling makes them experts so they can develop defence mechanisms We have to know where to google and which sites are reliable. AC is for one and ARUK (where the article comes from) is another.

Keep a diary and take a pic of that lump. Sometimes these things can take a long time to diagnose but, if you and your GP can work on it together, you'll get there.

Elmbow

Awesome, thank you. I didn't mention it to my GP for the reason you say - they are wary of patients who have done their own research. The reality is, in 2015, if something is wrong the first port of call is the internet - not a doctor. I find that nine times out of 10, the internet reassures you that it isn't something serious and actually prevents a trip to the doctor. Then again, I'm sure they still deal with malingerers every day.

dreamdaisy

Mr Google is a blessing to those who love to analyse every little twinge and pang to the nth degree and then tell the GP what's up with them. Those with a more intelligent view of things go and see those in the know and then maybe do some research once they have some insight as to what may be happening. To help those in the know we have to give as much background information as we can because we, as patients, cannot determine the relevance of the information.

I wonder how many people have ended up in boiling hot medical water because they believed what they read on the net so decided not to 'bother' their doctor. Words on a screen tell you very little especially when it comes to condition as complex as ours. My PsA is unique to me, it's not a unique condition but my version is. DD