Rheumatoid factor test, Waaler-Rose test and anti-CCP antibodies (rheumatoid arthritis)
The rheumatoid factor test, the Waaler-Rose test and anti-CCP (anti-citrulline) antibodies are laboratory tests recommended by the doctor to check whether a person has rheumatoid arthritis, a chronic, progressive degenerative disease that mainly affects the joints, causing serious difficulty in movement and deformities.
What they mean – RF (Rheuma) test:
• If the result is higher than normal, rheumatoid arthritis may be suspected (especially if there are also obvious symptoms such as pain in some joints, particularly in the morning).
Waaler-Rose test
If the report says “absent” or “negative”, rheumatoid arthritis can be ruled out, and specific tests will then be used to find out which other autoimmune disease is involved (for example, antinuclear antibody testing to see whether it is lupus erythematosus, and so on).
If the result is “present” or “positive”, the person has rheumatoid arthritis.
Anti-CCP antibodies:
If the report says “absent” or “negative”, the person does not have rheumatoid arthritis.
If the result is “present” or “positive”, the person has rheumatoid arthritis.
Why they are done
The rheumatoid factor test is a screening test to see whether a person has an autoimmune disease. If this test is abnormal, it is usually rheumatoid arthritis, the most common one. However, this test is also often abnormal in other autoimmune diseases, such as lupus erythematosus (a disease that, as well as affecting the joints, causes a skin rash on the face that was once likened to the face of a wolf), and others. To be certain that it is rheumatoid arthritis, it is therefore advisable to carry out the Waaler-Rose test for further investigation and confirmation. Until recently these were the tests available to doctors to detect the disease, based on the presence in the blood of so-called “rheumatoid factor”. However, its specificity is low, because it can be positive (i.e. present) in many rheumatic and infectious diseases and even in 3-5 per cent of healthy people. Anti-CCP (anti-citrulline) antibody testing, on the other hand, makes it possible to diagnose rheumatoid arthritis specifically and to identify people who have it even before joint damage has developed.
How they are done
These are simple blood tests. For these tests it is advisable to fast from the evening before. If you are taking medicines such as cortisone or immunosuppressants, you must tell your doctor, because these reduce the production of the antibodies being tested for and so distort the diagnosis (unless the tests are being done precisely to monitor treatment and check that the medicines are working).
Results
NORMAL VALUES
Rheumatoid factor 0-14 IU/ml
Waaler-Rose test negative or absent
Anti-citrulline antibodies (anti-CCP) negative or absent