Interpretative Information

CSF

Clinical Indications

• Not well-defined (non-routine)

Reference Interval and/or Interpretive Information

• Elevations in CSF rheumatoid factor (RF) have been observed in some cases of central nervous system rheumatoid meningitis. [1,2.3]

References

• [1] Nissen MS, Nilsson AC, Forsberg J, Milthers J, Wirenfeldt M, Bonde C, Byg KE, Ellingsen T, Blaabjerg M. Use of Cerebrospinal Fluid Biomarkers in Diagnosis and Monitoring of Rheumatoid Meningitis. Front Neurol. 2019 Jun 26;10:666. doi: 10.3389/fneur.2019.00666. PMID: 31293505; PMCID: PMC6606769.
• [2] Ii Y, Kuzuhara S. 2009. Rheumatoid cranial pachymeningitis successfully treated with long-term corticosteroid. Rheumatol Int. 29(5):583-5. PMID: 18807253.
• [3] Inan AS, Masatlioglu S, Ozyurek SC, Engin D, Erdem I. 2011. Unusual central nervous system involvement of rheumatoid arthritis: successful treatment with steroid and azathioprine. Rheumatol Int. 31(10):1383-5. PMID: 20012963.

PERICARDIAL

Clinical Indications

• Not well-defined (non-routine)

Reference Interval and/or Interpretive Information

• Anecdotal reports of the presence of RF in hemorrhagic pericardial effusion secondary to new onset RA.[1]
• Limited proven utility.

Reference

• [1] Basile E J, Thompson I, Rafa O, et al. (November 05, 2022) Hemorrhagic Pericardial Effusion as the Presenting Symptom of Newly Diagnosed Rheumatoid Arthritis. Cureus 14(11): e31123. doi:10.7759/cureus.31123 

PLEURAL

Clinical Indications

• Not well-defined (non-routine)

Reference Interval and/or Interpretive Information

• While pleural fluid rheumatoid factor (RF) may be detected in patients with rheumatoid pleural effusions and rheumatoid pleuritis, it is not specific for these conditions and/or may simply reflect serum concentrations. [1,2,3,4,5,6]

References

• [1] Levine H, Szanto M, Grieble HG, Back G, Anderson TO. 1968. Rheumatoid factor in nonrheumatoid pleural effusions. Ann Intern Med. 69(3):487-492. PMID: 5673168.
• [2] Allan JS, Donahue DM, Garrity JM. 2005. Rheumatoid pleural effusion in the absence of arthritic disease. Ann Thorac Surg. 80(4):1519-21. PMID: 16181910.
• [3] Balbir-Gurman A, Yigla M, Nahir AM, Braun-Moscovici Y. 2006. Rheumatoid pleural effusion. Semin Arthritis Rheum. 35(6):368-78. PMID: 16765714.
• [4] Karcher DS, McPherson RA. Chapter 29: Cerebrospinal, synovial, serous body fluids, and alternative specimens. In Henry’s Clinical Diagnosis and Management by Laboratory Methods. 22^nd Ed. McPherson RA, Pincus MR. Eds. Elsevier Saunders: Philadelphia, PA, 2011. ISBN: 1437709745.
• [5] Hassan T, Al-Alawi M, Chotirmall SH, McElvaney NG. 2012. Pleural fluid analysis: standstill or a work in progress. Pulm Med. 2012:716235. PMID: 22448326.
• [6] Kjeldsberg CR, Grenache DG, Couturier MR, Cohen MB. Chapter 5: Pleural and pericardial fluid. In Kjeldsberg’s Body Fluid Analysis. Hussong JW and Kjeldsberg CR, Eds. ASCP Press: Chicago, IL, 2015. ISBN: 978-089189-5824.

SYNOVIAL

Clinical Indications

• Not well defined (non-routine)

Reference Interval and/or Interpretive Information

• Synovial fluid rheumatoid factor (RF) measurements are generally not considered to be diagnostically helpful. [1,2]
• RF has been detected in synovial fluid in only ~60% of patients with rheumatoid arthritis, and typically in titers slightly lower than those observed in serum. [2]

References

• [1] Koopman WJ, Moreland LW. 2005. Arthritis and allied conditions: a textbook of rheumatology. Lippincott Williams & Wilkins: Philadelphia, PA. ISBN: 0-7817-4671-X.
• [2] Couturier MR, Straseski JA, Kjeldsberg CR. Chapter 7: Synovial fluid. In Kjeldsberg’s Body Fluid Analysis. Hussong JW and Kjeldsberg CR, Eds. ASCP Press: Chicago, IL, 2015. ISBN: 978-089189-5824.