Rheumatoid Factor Test Questions

I have a number of questions. Quick stats: I’m a 25 year old white female, acceptable weight and decent exercise, currently on the GF diet.

I’ve been experiencing a lot of health problems over the last year, and after various doctors and tests, I was diagnosed with Celiac sprue, with a possible comorbid fibromyalgia. I saw a Rheumatologist who gave me this second possibility – he did a few simple joint tests and took some blood to narrow it down. It seemed like there was nothing else wrong and life went on.

A couple of weeks ago, I got a message from him saying I had a test return positive. I was not told what test it was, but that it was “very specific for rheumatoid arthritis".  But my follow-up appointment isn’t until two weeks, and it’s driving me crazy.

Question 1: Is it reasonable to assume this was a Rheumatoid Factor test? It seemed the most likely, but I wasn’t sure if that was the first kind of test they would send out.

My second concern is this: the reason for these tests is because Lupus runs in my family – two cousins of my generation have it. If this test was for the Rheum Factor, I believe that brings Lupus in as a possibility. Is this true?

Question 3: Is it more likely to be Lupus considering my family background and age? Rheum Arth is typically diagnosed past 40, but I was told Lupus tends to show up in a person’s 20’s. I also don’t have any nodules or joint swelling, redness or warmth. On the Lupus side, I do not seem to have skin problems, but I know that doesn't occur in all patients. The rest of my symtoms (symptoms) are extreme fatigue, constant aching, frequent headaches, and possibly mental health issues like anxiety. These symptoms have not lessened with the GF diet (which did however cure my fainting spells).

Finally, are there any other tests I should request from my doctor going in? I know the ANA tests are used to diagnose Lupus, so I’m going to ask for those, but I know there are a lot of other diseases that would cause the Rheum Factor to be high. Should I get a white blood cell count, since Leukemia is an issue? An STD check, though I think it’s unlikely? Anything else?

[TrudieC]

I am not an expert on the tests but it is possible that since it has taken some time that the result he just got in was related to the ANA test.  He may have been waiting on it to rule out Lupus.  For RA the sed rate and CRP as well as the rheum factor are used.  

My rheumy is determining whether I have RA or Lupus.  I am 47.  They can be a challenge to diagnose.  I, too, don't have red swollen joints but do have the malar rash and he is leaning towards a Lupus diagnosis.  My ANA is positive one time and negative the next.  My RF is positive one time and negative the next.  Really ensure he knows your family background.  With Lupus it can time some time before the blood work shows positive.  You don't want an immediate RA diagnosis just because you aren't yet positive for Lupus.  The first round of treatment for both is ibuprofen and plaquenil.  It takes at least 3 months to start seeing results.  I am 6 months in and reallly seeing a difference now.

Please keep us posted and good luck.