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Really high rheumatoid factor

My mother had a blood test done a few weeks ago and came back with a rheumatoid factor of 528 (yes, that's 528!).  Her doctor has never seen anything so high and is quite confused about what might be wrong.  To my knowledge, lupus has been ruled out.  Any suggestions on what might be wrong would be greatly appreciated.
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A related discussion, High RA factor and ESR without symptoms was started.
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I tested 8.5 on Rheum Factor is it a four sure thing it is Rheumatiod Arthritis or can it be something else.
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Why did your mother have the test ? What are her symptoms ? Did her physician rule out other autoimmune conditions, such as rheumatoid arthritis and Sjogren's syndrome ?
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