关于血清湿性关节炎的10个基本事实

There are two types ofblood teststhat determine whether a person has rheumatoid arthritis. The first checks for the presence ofrheumatoid factor (RF): antibodies produced by the immune system that can attack healthy joints and tissues. The other looks for an antibody called the anticyclic citrullinated protein antibodies (ACPA), which is also considered a marker. When RF and ACPA tests do not reveal abnormally high levels of either antibody, but a person has symptoms similar to those of rheumatoid arthritis, they may be diagnosed with seronegative arthritis. People who have either RF or ACPA antibodies have seropositiveRA.

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Here are 10 things you should know about seronegative rheumatoid arthritis.

1. Doctors Rely on Symptoms to Diagnose Seronegative RA, Not Just the Results From Blood Tests

Since blood work doesn’t tell the whole story, your doctor will want to find out if you’re experiencing these key symptoms:

• 炎症关节疼痛
• 晨僵​​，手中的一小时以上，膝盖，肘部，臀部，脚或脚踝
• Jointswelling, tenderness or pain, and sometimes redness. Typically, RA affects distal joints symmetrically
• 对称地呈现在身体和多个关节上的症状
• Fatigue

X-rays can also help your doctor make a diagnosis by showing signs of erosions or other changes in your bones.

2. RF或ACPA的存在或不存在不会制造或破坏RA诊断

Testing forrheumatoid factor在涉嫌拥有RA的人民在20世纪60年代普及，专家们仍然没有完全理解这些因素与疾病发展之间的确切联系。rf在多种疾病中可以是阳性的，例如hepatitis C,endocarditis, andmultiple myeloma.

“Rheumatoid factorclearly plays a role in how serious rheumatoid arthritis can be,” says John J. Cush, MD, a professor of internal medicine and rheumatology at UT Southwestern Medical Center in Dallas. A different blood test checks for ACPA, which may be more closely linked to the development of the disease than RF. Astudy published in the journalAutoimmunity Reviewsin July 2016found that ACPA antibodies represent an independent risk factor for developing RA. Having ACPA suggests there’s a genetic risk factor for the disease, but it’s not necessary for either antibody to be present in the blood for a diagnosis of seronegative RA.

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3. Seronegative RA Has Become More Common in Recent Years

According to CreakyJoints, a support, education, advocacy, and research organization for people living with arthritis andrheumaticdisease, the majority of rheumatoid arthritis patients are seropositive. But while you’re far less likely to be diagnosed with the seronegative type of the disease, those numbers are on the rise, according to astudy published in the March 2020 issue ofAnnals of the Rheumatic Diseases. Between 1985 and 1994, only 12 out of 10,000 people with RA were seronegative. Between 2005 and 2014, that number crept up to 20 out of 10,000.

4. People With Seronegative RA Often Have Different Symptoms

传统智慧是血清阳性患者具有更严重的症状，但最近的研究表明，两种形式的疾病之间的差异可能与受影响的关节有关ra症状. And a2016年6月发布的报告BMC Musculoskeletal Disordersfound that further research is needed to better understand the long-term outcomes of patients with seronegative RA. “My experience has been that while the symptoms are similar, seronegative patients are more difficult to treat,” saysVinicius Domingues，MD, arheumatologistin Daytona Beach, Florida, and a medical adviser to CreakyJoints.

5. Seronegative RA Could Become Seropositive Down the Road

Your rheumatoid arthritis markers may change over time from negative to positive, since many people with seronegative rheumatoid arthritis begin to develop RF or ACPA antibodies. “It happens, but it’s not that common,” says Dr. Domingues. Dr. Cush says people with seronegative rheumatoid arthritis may start to develop RF or ACPA within the first two years of diagnosis.

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6.血清磷湿性关节炎不需要与血清阳性不同的方式对待

The treatment options available don’t really differ regardless of what form of the disease you have. “Whether you are diagnosed with negative or positive, be aggressive in treatment and stay ahead of the disease,” advises Cush. The purpose of treatment in either case is to lessenpain和slow or prevent progression. “Remission as early as possible is the goal,” he says.

Standard drug therapy in early disease includes nonsteroidal anti-inflammatory drugs, such asibuprofen(Advil要么Motrin) orCelebrex (celecoxib)to help relieve symptoms, and a class of drugs known as disease-modifying antirheumatic drugs (DMARDs),可以帮助改变的the disease, says Domingues.DMARDsinclude methotrexate (Trexall., Rheumatrex, Otreup, Resuvo) andhydroxychloroquine (Plaquenil). More powerful drugs known as biologics can be prescribed for more severe cases.

7. Seronegative RA May Not Be the Correct Diagnosis

According to Cush and Domingues, a small percentage of people with the seronegative form of RA will do very well on therapy and go into remission, and others will experience severe disease and require medication. And still others will not respond to conventional treatment, which may be because they don’t have RA at all.Spondyloarthritisconditions, which often affect the spine, are sometimes mistaken for seronegative rheumatoid arthritis.

8. New Symptoms May Change the Diagnosis

Eventually, people with seronegative disease may be diagnosed with a different disease altogether, according to theArthritis Foundation. If, say, a person diagnosed with seronegative RA develops askin rash, her diagnosis might change topsoriatic arthritis. Other changes or new test results could lead to a new diagnosis of chronic痛风要么osteoarthritis. “The most important thing at the time you see a rheumatologist is determining whether you have inflammatory arthritis or mechanical arthritis, where there is less that can be done to treat it,” says Domingues.

9. There Is No Way to Predict the Future Severity of Seronegative RA

Forecasting how any disease may progress is extremely difficult. Whether you’re diagnosed with seronegative or seropositive, there are no set expectations of how either form of the disease will play out in an individual. “Which type you have isn’t all that important, since you treat them both the same way,” says Domingues.

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10. Seronegative RA Is Sometimes Linked to Having Higher Levels of Inflammation Than Seropositive

In a European study of 234 people who had bothtypes of rheumatoid arthritis和had experienced symptoms for less than two years, those with seronegative RA showed higher levels ofinflammation根据research published in January 2017 inAnnals of the Rheumatic Diseases.