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Rheumatoid Factor

Aka: Rheumatoid Factor, RF

I. Normal

  1. Negative

II. Mechanism

  1. IgM (rarely IgG) Antibody
    1. Binds IgG constant region (crystallizable fragment)
  2. Serum Detection
    1. Latex fixation
      1. Agglutination of latex particles
      2. Latex coated with human IgG
    2. Sheep Cell Agglutination assay indications
      1. Negative latex fixation despite high suspicion

III. Causes of Rheumatoid Factor (RF) presence

  1. Rheumatoid Factor present in normal persons
    1. Very Low titers (<1:80) present in many patients
    2. Normally present in 1-5% of general population
    3. Incidence of RF increases with age
    4. Incidence of RF in ages over 65 years: 10%
  2. Rheumatoid Arthritis
    1. Prognosis worse with high titer at onset
    2. RF Incidence increases with duration of disease
      1. Three months: 33%
      2. Six months: 45%
      3. One year: 75%
      4. Eighteen months: 90%
      5. Up to 20% of RA patients remain seronegative
  3. Other Autoimmune disease
    1. Sjogren's Syndrome (75 to 95%)
    2. Systemic Lupus Erythematosus (15 to 35%)
    3. Scleroderma (20 to 30%)
    4. Polymyositis or Dermatomyositis (10%)
    5. Cryoglobulinemia (40 to 100%)
    6. Mixed connective tissue disease (50 to 60%)
  4. Infections
    1. Bacterial Endocarditis
    2. Osteomyelitis
    3. Tuberculosis
    4. Syphilis
    5. Hepatitis (Acute and Chronic)
    6. Mononucleosis
    7. Infection following vaccination
  5. Other Conditions
    1. Diffuse interstitial pulmonary fibrosis
    2. Hepatic Cirrhosis
    3. Primary biliary Cirrhosis
    4. Sarcoidosis

IV. Conditions not associated with elevated RF

  1. Osteoarthritis
  2. Ankylosing Spondylitis
  3. Gout
  4. Chondrocalcinosis
  5. Suppurative Arthritis
  6. Psoriatic Arthritis
  7. Enteropathic Arthritis
  8. Reiter's Syndrome

V. References

  1. Shmerling (1991) Am J Med 91:528-34 [PubMed]

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Ontology: Fanconi Syndrome (C0015624)

Definition (NCI) A genetic or acquired disorder characterized by impairment of the function of the proximal tubules of the kidney. It results in decreased reabsorption of electrolytes, glucose, amino acids, and other nutrients.
Definition (MSH) A hereditary or acquired form of generalized dysfunction of the PROXIMAL KIDNEY TUBULE without primary involvement of the KIDNEY GLOMERULUS. It is usually characterized by the tubular wasting of nutrients and salts (GLUCOSE; AMINO ACIDS; PHOSPHATES; and BICARBONATES) resulting in HYPOKALEMIA; ACIDOSIS; HYPERCALCIURIA; and PROTEINURIA.
Concepts Disease or Syndrome (T047)
MSH D005198
SnomedCT 40488004
English Fanconi Syndrome, Syndrome, Fanconi, FANCONI SYNDROME, Proximal Renal Tubular Dysfunction, Proximal renal tubular dysfunction, Fanconi Syndrome [Disease/Finding], fanconis syndrome, nephropathic cystinosis, fanconi syndrome, Fanconi syndrome (diagnosis), Fanconi's syndrome, Fanconi syndrome, Fanconi syndrome (disorder), Fanconi, Fanconi syndrome, NOS, Lignac-Fanconi Syndrome
Portuguese SINDROME DE FANCONI, Disfunção tubular renal proximal, Disfunção Tubular Renal Proximal, Síndrome de Fanconi Renal, Síndrome de Fanconi
Spanish SINDROME DE FANCONI, Disfunción tubular renal proximal, Disfunción Tubular Renal Proximal, Síndrome de Fanconi Renal, síndrome de Fanconi (trastorno), síndrome de Fanconi, Síndrome de Fanconi
Dutch syndroom van Fanconi, proximale renale tubulaire disfunctie, Congenitale hypoplastische anemie, Constitutionele infantiele panmyelopathie, DeToni-Debre-Fanconi syndroom, DeToni-Fanconi syndroom, Fanconi's anemie, Fanconi's pancytopenie, Fanconi's syndroom, Lignac syndroom, Lignac-Fanconi syndroom, Pancytopenie dysmelie syndroom, Syndroom, Fanconi's
French Dysfonction des tubes rénaux proximaux, SYNDROME DE FANCONI, Diabète phospho-gluco-aminé, Syndrome de Fanconi, Syndrome de De Toni-Debré-Fanconi
German proximale Nierentubulusdysfunktion, DEBRE-DE-TONI-FANCONI SYNDROM, Fanconi-Syndrom
Italian Disfunzione tubulare renale prossimale, Sindrome di De Toni-Debré-Fanconi, Sindrome di Lignac-Fanconi, Sindrome renale di Fanconi, Sindrome reno-tubulare di Fanconi, Sindrome tubulare renale di Fanconi, Sindrome di Fanconi
Japanese 近�腎尿細管機能障害, ﾌｧ�ｺﾆｰｼｮｳｺｳｸﾞ�, ｷ�ｲｼﾞ�ﾆｮｳｻｲｶ�ｷﾉｳｼｮｳｶﾞｲ, Lignac-Fanconi症候群, ファンコニー症候群, ファンコニ症候群, ドトーニ･デブレ･ファンコニ症候群, 近�尿細管機能�全, ファンコーニ症候群, De Toni-Debre-Fanconi症候群, Fanconi症候群
Swedish Fanconis syndrom
Czech Fanconiho syndrom, Proximální renální tubulární dysfunkce
Finnish Fanconin oireyhtymä
Russian FANKONI SINDROM, LIGNASA-FANKONI SINDROM, DE TONI-DEBRE-FANKONI SINDROM, POCHECHNYKH PROKSIMAL'NYKH KANAL'TSEV DISFUNKTSIIA, PROKSIMAL'NYKH POCHECHNYKH KANAL'TSEV DISFUNKTSIIA, ДЕ ТО�И-ДЕБРЕ-Ф��КО�И СИ�ДРОМ, ЛИГ��С�-Ф��КО�И СИ�ДРОМ, ПОЧЕЧ�ЫХ ПРОКСИМ�ЛЬ�ЫХ К���ЛЬЦЕВ ДИСФУ�КЦИЯ, ПРОКСИМ�ЛЬ�ЫХ ПОЧЕЧ�ЫХ К���ЛЬЦЕВ ДИСФУ�КЦИЯ, Ф��КО�И СИ�ДРОМ
Polish Zespół de Toniego-Debre-Fanconiego, Zespół Fanconiego
Hungarian Fanconi-syndroma, Proximalis renalis tubularis működési zavar
Norwegian Fanconis syndrom
Derived from the NIH UMLS (Unified Medical Language System)

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