GLOBAL DIAGNOSTIC LABORATORY Opp.GOVT.Kot Khawaja Saeed Teaching Hospital, Lahore. 0346-4542144 : What is an antinuclear antibodies (ANA) test and how is it used to diagnose rheumatoid arthritis? The immune system is there to stop invaders. So, basically, if we get an infection, the immune system works like a Star Wars and kills the invader. Unfortunately, in some people, related to genetic pre-disposition and various triggers in the environment, the immune system can work against self and thats called autoimmunity. There are specific types of autoantibodies that can be found in people with various types of arthritis. For example, in systemic lupus erythematosus, which is an illness of young women mostly, who have many inflammatory problems such as arthritis, kidney disease, brain problems and skin rash, they have significant amount of auto antibodies called antinuclear antibodies. The reasons they are called that is because on special tests in the laboratory, these specific antibodies target the nucleus of the cell. In some people with rheumatoid arthritis, they also have antinuclear antibodies. Its important to note that in rheumatoid arthritis, that the most prominent autoantibodies are rheumatoid factors and anti-CCP antibodies. And the presence of those bode for more severe disease and potential damage, unless the illness is controlled by new medicines. : What is a rheumatoid factor test and how is it used to diagnose rheumatoid arthritis? Rheumatoid arthritis, like many of the things that we see in rheumatology, is an autoimmune disease in which the bodys own immune system is working against itself. Rheumatoid factor is one manifestation of this, and rheumatoid factor is a measurement of antibodies that are actually directed against the bodys own proteins. We have found that this is associated with rheumatoid arthritis. Its not clear that it actually causes the disease or even worsens the disease, but we know that its associated. And we also know that patients who have high levels of these rheumatoid factor antibodies are more likely to have severe disease and more likely to have destructive disease. : How important is early diagnosis when it comes to rheumatoid arthritis? Early diagnosis of rheumatoid arthritis is critical. For many years, we looked at treating this disease depending on how severe it was in individual patients. We know that this is a chronic disease, and many people begin to get joint damage over time. And we often tailored therapy to the severity of that joint damage. That has changed quite a bit in the last ten years or so. Weve come to recognize that the vast majority of patients with rheumatoid arthritis -- perhaps 90 percent or more -- will begin to get damage to their joints within the first year or two of disease. And once that damage happens, it cant be reversed. And so now, the goal in treating rheumatoid arthritis is to initiate therapy early before the damage has happened so that we can prevent long term structural damage and long term problems with disability. So early treatment and aggressive treatment is really the watchword at this point -- getting the disease before it does its damage and not waiting til after the fact. : How is rheumatoid arthritis diagnosed, and what are the most common tests used in the process? The diagnosis of rheumatoid arthritis is one by history. Somebody who has had arthritis for more than three months in a joint and then get it in another joint, somebody who gets arthritis in both sides of the body -- both hands, both knees, both shoulders -- historically, its very important to see how this arthritis develops. And then there are examinations, which show the specific swelling in the hands, wrists, both sides of the body, most of the joints. And then there are laboratory tests, such as rheumatoid factor, another test call anti-CCP which confirms the diagnosis in rheumatoid in more than 80 percent of patients who have it. : What are common symptoms of rheumatoid arthritis? Well, rheumatoid arthritis is the prototype of all inflammatory arthritic problems. The difference between rheumatoid, lets say, and osteoarthritis is that in rheumatoid arthritis most joints are inflamed rather than just being painful and they are stiff. And the entire body gets involved in the process of arthritis, because from the inflamed joints there are materials released in the body called cytokines that cause fatigue, fever and stiffness in the entire body. And thats what really makes the rheumatoid a specific type and very serious type of arthritis. GLOBAL DIAGNOSTIC LABORATORY Opp:GOVT.Kot Khawaja Saeed Teaching Hospital ,Lahore… 0346-4542144 E-mail: gdllabkks@gmail
Posted on: Sat, 18 Jan 2014 09:13:28 +0000
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