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Clueless about the disease activity

I am a 25 year female who was diagonized with RA in 2013 after having mild pain in shoulder followed by swelling in the ankle. I went to see a Rheumatologists within a month. The doctor took complete blood tests to see my RF- 54 and Anti-CCP- 40 and others blood tests were normal. He put me in 15mg of MTX and Hydroxycholorquine 200 and Folic acid 5mg tablets. After the first incident on 2013 that I had no flare, no morning stiffness. I continued and still continuing those medications. Recently, in April 2016, I took up blood test to see that my RF factor went to 34 whereas my Anti CCP rocketed to 453 UI/ml CRP is 0.463 (normal). Still I don't find any flare or morning stiffness. Since the CRP was less the internal medicine doctor said there are no inflammations however it is better to consult my Rheumatologist.
I am clueless of sharp increase of my anti CCP value and decrement of RF factor. Is this something serious to be taken care regarding the change of medications? Is my disease evolving?

  1. Hi Manish, Thanks for reaching out with your question! I would definitely consult your rheumatologist about this, as s/he will be best qualified to determine what these lab results mean for you specifically. I am seronegative (my standard lab results always "look good" whether I'm feeling great or in the middle of a severe flare), so I don't see a spike in my labs when I flare. You seem to be the opposite, spiking even though you feel fine. This speaks to the need for better tests, which is referenced in this article: https://rheumatoidarthritis.net/living/better-diagnostic-and-individualized-tests-for-ra-needed/. In addition, here's an article about anti-CCP: http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/84182. Please feel free to update us after you check in with your doctor! Wishing you all the best, Tamara (Site Moderator)

    1. Thank you Tamara. I will definitely consult my Rheumy. I will update you with the details once I have them. This may help many.

      Best wishes to you too.

      1. Hi Manish1~

        As Tamara points out, your rheumatologist is the best person to interpret the lab results that are particular to your case. One of the more frustrating aspects of RA is that there is no one specific lab test to confirm diagnosis or even disease activity, so we have to rely on a combination of tests as well as the expertise of our doctors. However, it is important to remember that it is your doctor's job to answer your questions and make sure you understand your diagnosis and treatment options - so ask as many questions as you like and keep asking until you understand the answers!

        As an aside, I was also diagnosed with RA at 25 - so I know it's not an easy thing to go through at that age! Please remember that we understand what you are going through and we are here to support you!

        ~Mariah~ (Site Moderator)

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