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IgA rheumatoid factor in rheumatoid arthritis. 2022
Lieve Van Hoovels, and
Bert Vander Cruyssen, and
Daniela Sieghart, and
Carolien Bonroy, and
Eszter Nagy, and
Rille Pullerits, and
Saša Čučnik, and
Charlotte Dahle, and
Ingmar Heijnen, and
Luca Bernasconi, and
Farid Benkhadra, and
Laura Bogaert, and
Stefanie Van Den Bremt, and
Ann Van Liedekerke, and
Geert Vanheule, and
Johan Robbrecht, and
Lucy Studholme, and
Claudine Wirth, and
Rüdiger Müller, and
Diego Kyburz, and
Christopher Sjöwall, and
Alf Kastbom, and
Rok Ješe, and
Boja Jovancevic, and
Emese Kiss, and
Peggy Jacques, and
Daniel Aletaha, and
Guenter Steiner, and
Patrick Verschueren, and
Xavier Bossuyt
Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.
Rheumatoid factor (RF) is a well-established marker for the diagnosis and classification of rheumatoid arthritis (RA). Most studies evaluated IgM RF or isotype-nonspecific total RF assays. We evaluated the added value of IgA RF in this context. An international sample cohort consisting of samples from 398 RA patients and 1073 controls was tested for IgA RF with 3 commercial assays. For all RA patients and 100 controls essential clinical and serological data for ACR/EULAR classification were available. The sensitivity of IgA RF for diagnosing RA was lower than the sensitivity of IgM RF. Differences in numerical values between IgA RF assays were observed. With all assays, the highest IgA RF values were found in patients with primary Sjögren's syndrome. Double positivity for IgM RF and IgA RF had a higher specificity for RA than either IgM RF or IgA RF. The sensitivity of double positivity was lower than the sensitivity of either IgA RF or IgM RF. Single positivity for IgA RF was at least as prevalent in controls than in RA patients. Adding IgA RF to IgM RF and anti-citrullinated protein antibodies (ACPA) did not affect RA classification. However, combined positivity for IgA RF, IgM RF and IgG ACPA had a higher specificity and lower sensitivity for RA classification than positivity for either of the antibodies. IgA RF showed a lower sensitivity than IgM RF. Combining IgA RF with IgM RF and ACPA did not improve sensitivity of RA classification. Combined positivity (IgA-RF/IgM-RF/ACPA) increased specificity.
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Rok Ješe, and
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