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Test Code RFPN Rheumatoid Factor Panel, Serum


Additional Testing Requirements


Rheumatoid factor (RF) IgA and RF IgM should be tested in combination with CCP / Cyclic Citrullinated Peptide Antibodies, IgG, Serum; or following positive or equivocal results for either RHUT / Rheumatoid Factor, Serum; or RAPAN / Rheumatoid Arthritis Panel, Serum.



Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.


Secondary ID

621421

Useful For

Evaluating patients at-risk of rheumatoid arthritis (RA) or features of inflammatory arthritis

 

Differentiating the antibody isotype profile in patients positive for rheumatoid factor (RF)

 

Aid in the risk stratification of RF-seropositive patients with RA

Profile Information

Test ID Reporting Name Available Separately Always Performed
RFA Rheumatoid Factor IgA, S No Yes
RFM Rheumatoid Factor IgM, S No Yes

Method Name

Chemiluminescent Immunoassay

Specimen Type

Serum

Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  28 days
  Ambient  48 hours

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject
Heat-treated specimens Reject

Reference Values

RHEUMATOID FACTOR, IgA

Negative: <20 CU

Positive: ≥20 CU

Reference values apply to all ages.

 

RHEUMATOID FACTOR, IgM

Negative: <5.0 IU/mL

Positive: ≥5.0 IU/mL

Reference values apply to all ages.

Interpretation

The presence of rheumatoid factor (RF) IgM or IgA at abnormal levels in association with anti-citrullinated peptide/protein antibodies has high specificity for a diagnosis of rheumatoid arthritis (RA). However, the presence of RF isotypes in any combination may be found in a variety of conditions, including Sjogren syndrome and hepatitis infections.

Method Description

The Inova BIO-FLASH system uses paramagnetic beads as the solid surface upon which to bind the targeted antibody. The beads used in the rheumatoid factor (RF) IgA and IgM kits are coated with rabbit polyclonal antibodies as the capture antigen. The serum sample is diluted by the instrument and combined in a cuvette with the beads and assay buffer for 10 minutes at 37° C. The beads are magnetized, and unbound materials are washed away. Detection antibody conjugated with isoluminol is added to the cuvette for another incubation at 37° C. The RF IgA kits contain anti-human IgA conjugate, while the RF IgM kits contain anti human IgM conjugate. After an additional wash, trigger reagents are added to the cuvette to initiate a light reaction proportional to the amount of bound isoluminol conjugate. The light produced by the reaction is measured by a detector as relative light unit (RLU). The RLU is applied to the working curve on the instrument. The RF IgA is reported as chemiluminescent units (CU), while the RF IgM is reported in IU/mL traceable to WHO Reference Reagent W1066.(Package inserts: QUANTA Flash RF IgA. Inova Diagnostics, Inc; V 4, 07/2019; QUANTA Flash RF IgM. Inova Diagnostics, Inc; V 4, 07/2019)

Day(s) Performed

Wednesday

Report Available

2 to 7 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

86431 x2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
RFPN Rheumatoid Factor Panel, S 106053-2

 

Result ID Test Result Name Result LOINC Value
RFM Rheumatoid Factor IgM, S 9338-5
RFA Rheumatoid Factor IgA, S 33313-8