Rheumatoid Factor

Overview

Rheumatoid factor (RF) measures autoantibodies, primarily IgM, directed against the Fc portion of IgG immunoglobulins in serum. It reflects immune complex formation and B-cell activation relevant to autoimmune processes. Elevated levels may indicate rheumatoid arthritis, Sjögren’s syndrome, or other autoimmune conditions, while low levels are typical in healthy individuals; it is clinically useful for supporting rheumatoid arthritis diagnosis, assessing disease severity, and monitoring treatment response, though specificity is limited as it can appear in infections and other disorders.

Clinical Use Cases

  • Supporting diagnosis of rheumatoid arthritis (with other criteria).
  • Assessing prognosis in RA (higher titers correlate with erosive disease).
  • Evaluating Sjögren’s syndrome and mixed connective tissue disease.
  • Monitoring disease activity and treatment response.
  • Investigating chronic infections or malignancies with positive RF.

Specimen Types

  • Serum.
  • Plasma (less common).

Measurement Methods

  • Nephelometry (quantitative, common).
  • Turbidimetry.
  • Latex agglutination (semiquantitative screening).
  • Enzyme-linked immunosorbent assay (ELISA).

Test Preparation and Influencing Factors

  • No fasting required.
  • No specific timing restrictions.
  • Elevated nonspecifically in infections, liver disease, cancer, or aging.
  • Immunosuppressive therapy may lower levels.
  • Sample hemolysis or lipemia can interfere with assays.

Synonyms

  • RF.
  • IgM rheumatoid factor.

Further Reading

  • “Rheumatoid Factor (RF) Test” – MedlinePlus –