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dc.contributor.authorJonsson, T
dc.contributor.authorSteinsson, K
dc.contributor.authorJonsson, H
dc.contributor.authorGeirsson, A J
dc.contributor.authorThorsteinsson, J
dc.contributor.authorValdimarsson, H
dc.date.accessioned2009-01-20T16:18:49Z
dc.date.available2009-01-20T16:18:49Z
dc.date.issued1998-10-01
dc.date.submitted2009-01-20
dc.identifier.citationRheumatol. Int. 1998, 18(3):119-22en
dc.identifier.issn0172-8172
dc.identifier.pmid9833253
dc.identifier.doi10.1007/s002960050069
dc.identifier.urihttp://hdl.handle.net/2336/47767
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractThe diagnostic value of measuring rheumatoid factor (RF) by agglutination or isotype-specific enzyme-linked immunosorbent assay (ELISA) was compared. The study included 70 patients with rheumatoid arthritis (RA) and 205 patients with various other rheumatic conditions. Of the RA patients, 74% were RF-positive by agglutination and 90% had one or more RF isotypes elevated by ELISA compared to 14% and 22%, respectively, of the other patients. Strikingly, 70% of the RF-positive RA patients had an elevation of two or more RF isotypes compared to only 16% of the other RF-positive patients (P < 0.0001). Furthermore, a combined elevation of IgM and IgA RF was found in 52% of the RF-positive RA patients, but only in two (4%) of the other RF-positive patients (P < 0.0001). It is concluded that a combined elevation of IgM and IgA RF is highly specific for RA and is very rarely found in rheumatic diseases other than RA. Isotype-specific RF assays are therefore diagnostically superior to agglutination tests. The detection of the RA-specific RF isotype pattern may be particularly helpful early in the course of RA even before the disease is fully differentiated.
dc.language.isoenen
dc.publisherSpringer Internationalen
dc.relation.urlhttp://www.springerlink.com/content/14d5h6m2c1eev11men
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAged, 80 and overen
dc.subject.meshAgglutination Testsen
dc.subject.meshArthritis, Rheumatoiden
dc.subject.meshEnzyme-Linked Immunosorbent Assayen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshImmunoglobulin Aen
dc.subject.meshImmunoglobulin Men
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshRheumatoid Factoren
dc.subject.meshSensitivity and Specificityen
dc.titleCombined elevation of IgM and IgA rheumatoid factor has high diagnostic specificity for rheumatoid arthritisen
dc.typeArticleen
dc.contributor.departmentDepartment of Immunology, National University Hospital, Reykjavik, Iceland.en
dc.identifier.journalRheumatology internationalen
html.description.abstractThe diagnostic value of measuring rheumatoid factor (RF) by agglutination or isotype-specific enzyme-linked immunosorbent assay (ELISA) was compared. The study included 70 patients with rheumatoid arthritis (RA) and 205 patients with various other rheumatic conditions. Of the RA patients, 74% were RF-positive by agglutination and 90% had one or more RF isotypes elevated by ELISA compared to 14% and 22%, respectively, of the other patients. Strikingly, 70% of the RF-positive RA patients had an elevation of two or more RF isotypes compared to only 16% of the other RF-positive patients (P < 0.0001). Furthermore, a combined elevation of IgM and IgA RF was found in 52% of the RF-positive RA patients, but only in two (4%) of the other RF-positive patients (P < 0.0001). It is concluded that a combined elevation of IgM and IgA RF is highly specific for RA and is very rarely found in rheumatic diseases other than RA. Isotype-specific RF assays are therefore diagnostically superior to agglutination tests. The detection of the RA-specific RF isotype pattern may be particularly helpful early in the course of RA even before the disease is fully differentiated.


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