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Discussion:
Seronegative RA?
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I have a question for those with seronegative RA.

Which of your blood tests have come back positive and which have come back negative?

I've had the following..

CRP-normal
Rheumatoid factor- normal
CBC- normal.
ANA-positive
Sed Rate- positive.

My doctor ran the anti-CCP and I'm going back tomorrow to get the results.

I'm just wondering if I have 'not enough' positive blood work to be considered sero-negative. I have all the symptoms (swollen, hot, red, sore, stiff, loss of movement in both knees and fingers, dry eyes, Raynaud's and more), I'm on 20mg Prednisone and it helps a lot! My doctor (and the hospital rheumy) said it's definitely some sort of autoimmune inflammatory arthritis. I'm a 21 year old female.

Thanks.
Posted on 05/26/11, 08:50 am
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Reply #1 - 05/26/11  9:41am
" The only thing that came back positive for me was the ANA. Oh, I did have some elevated thrombocytes (platelets) on the CBC until I was on methotrexate. RF was negatve, anti CCP negative, ESR negative, CRP negative.

You can be negative on ALL of them and still have RA. And the fact that your RF was negative means that your anti-CCP is likely to be negative also.

Lack of positive labs in the presence of characteristic symptoms and clinical findings should not deter the doc from finding a diagnosis of seronegative RA, IMHO. "
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Reply #2 - 05/26/11  9:44am
" Wabby,
There are some other posts on this if you want to look them up for a more complete compilation for your question.

All of my blood work was negative except for my anemia level which was very low and I showed exposure to the parvo virus (human not animal, I was exposed to my son who had fiths disease and this is how I came in contact with parvo).

My x-rays showed no osteoarthritis which was part of my Rheumy being able to diagnose me as sero negative RA.

I have been fortunate to have a Rheumy who can diagnose sero negative Ra when it is in the early stages.

My symptoms are as follows:
Joint pain in 53 joints.
Swollen, red joints
low grade fever
onset of symptoms following a bad bacterial infection (pneumonia)
Symptoms rapidly developing over a 4 month period.
extreme fatigue
morning joint stiffness lasting at least 3 hrs. sometimes more
symptoms in same joints on both sides of my body
2 nodules (one on my ankle and one on a finger)

Hope this answers your question. I have several other issues I think are probably related to the RA, but they are not considered markers for diagnosis. "
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Reply #3 - 05/26/11  5:02pm
" All of mine were negative except the sed rate. I was diagnosed through number of swollen joints, pain symmetry, and through response to medication (pred, plaq). Of course, the first time at the rheum they said I had nothing (joints not swollen while I was there), but I went in the second time when all my joints were screamin'!

Based on everything I've read, glad I found a doctor who believes in treating early.. "
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Reply #4 - 05/26/11  5:44pm
" I had a positive sed rate and Anti-ccp. RF and one other were negative. I am still dx with RA.

Good luck with the testing....I know it can be a nightmare trying to get to the bottom if it all.

Marianne "
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Reply #5 - 05/26/11  8:43pm
" The only thing postive on my blood tests so far is CRP...high, but not really all that high. My PCP said I have had a postive SED rate once in a while over the years. My rheumy is doing another blood test in about four weeks. I just started MTX last Friday. She said I may never be postive, or I might eventually have a postive RF. Regardless of the blood tests, she said I definitely have seronegative RA. "
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Reply #6 - 05/26/11  11:33pm
" Thanks all.

My doctor said today that the way I responded to Prednisone is a better indicator that something is going on than any blood test could be. "
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Reply #7 - 05/27/11  4:22am
" Wabby hello I hope you are doing okay. I am new to this site and actually you are my first response. I am not diagnosed with RA yet but I have a feeling my time will be soon. I have all the same symptoms as you except mine are in my ankles, knees, hips, elbows and wrists. No dry eyes or Raynaud's yet but I did have nodules before I started prednisone. My labs are all normal except a high sed rate and low compliment. This was not surprising to me because both of these are markers for inflammation. Well given the fact that my ankles were triple in size I knew inflammation was present, duh.

I am a med tech and I work in the lab. I know what all these tests mean and I know how doctors use them to diagnose. I am certified by American Society of Clinical Pathology (ASCP) so if you have any questions about any tests and why they do them I would be happy to help if I can. I am no doctor but sometimes it's nice to know why your getting picked and poked all the time.

From the tests you listed CRP and sed rate are both markers for inflammation. They are not specific to RA but aid in a diagnosis. RA factor and CCP are both 2 kinds of auto anti bodies. These are specific to RA but can be present in other auto immune diseases too. A positive anti nuclear antibody can be caused by a number of things. Did your doctor specify a pattern of ANA or just tell you it was positive? Different patterns of ANA can be specific for certain auto immune diseases. Sometimes it's useful sometimes it's not. Super frustrating I know.

I am not positive but I think with out a positive RA factor or a positive CCP but all the symptoms and various other things you can be considered sero neg RA. I am not sure if you would be considered sero neg with a positive ANA or not, ask your doc about that.

The truth is they don't know much about RA and it varies so much from person to person that diagnosis is specific to you.

Good luck to you I hope this helped a little:) "
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Reply #8 - 05/27/11  9:30pm
" Shannon- Thank you for replying!

It sounds like your painful joints are more wide spread than mine. I'm 'fortunate' that I'm only dealing with my knees and fingers, but there are days when my wrists hurt and I think 'oh no, what if they're next?'.. but they seem to be ok at the moment. I'm just hoping it stays that way.

I have had Raynaud since I was at least 17. My knees started hurting in November 2010, my fingers were puffy around then too, but the only thing I noticed was it was difficult to get my rings on and off. Then they started hurting in about March. Then dry eyes in April and last month I've had swelling in my knees and fingers that have been pretty obvious to the eye. I can't straighten my fingers and knees, hot, red joints.. It's just gotten worse in general.

I haven't had any nodules.

I would have excepted my blood tests to show more inflammation, but I had been taking ibuprofen maximum dose each day for about 2-3 months when I got the blood tests. I've been told this could show no inflammation on the blood tests.

Thank you. I really appreciate it. I'm wondering though, my doctor retested all the ones that were negative, but didn't retest the positive one? Does this mean that they were happy to assume that the positives were correct and waiting to see if the negatives become positives?

Why would my Sed Rate be elevated, but not the CRP?

My ANA was speckled

I know that my GP can't give me much more help, so I know I have to wait and see a rheumatologist, it's just frustrating to wait.

Thank you =] "
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Reply #9 - 05/27/11  10:40pm
" all my blood work came back fine, even the inflammation markers which I was real surprised since my ankles were huge. all that swelling and it still didn't show up on blood work. "
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Reply #10 - 05/27/11  11:04pm
" Sandi- that's crazy, you'd expect the blood tests to be up when you can see the swelling!

Did they diagnose you based on your symptoms alone? "

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