Rheumatic factor Ask the master to answer the answer

Rheumatoid factor is an anti-IgG immunoglobulin produced in the body, which is synthesized and secreted into synovial fluid and blood, mainly by plasma cells of the synovium, but also by plasma cells of the spleen, lymph nodes, and rheumatoid subcutaneous nodules.

Clinical significance of the word rheumatoid factor.

The RF positivity rate in typical and definite rheumatoid patients is only about 80%, and the positivity rate is lower in atypical and nasty cases;

RF positivity can also occur in other connective tissue diseases, other chronic inflammation and malignant tumors, such as rheumatic fever, systemic lupus erythematosus, dermatomyositis, psoriasis, sarcoidosis, chronic hepatitis, liver cirrhosis, tuberculosis, tracheitis, >chronic bronchitis, subacute bacterial endocarditis, syphilis, leprosy, silicosis, bladder tumors, leukemia, etc.;

The positive rate of rheumatoid factor in the normal population is about 5%, and the positive rate in the elderly can reach about 20%;

Rheumatoid factor is more common in rheumatoid patients with extra-articular lesions, such as subcutaneous nodules, vasculitis, cardiopulmonary damage, etc.;

The higher the titer of rheumatoid factor, the earlier it appears, the more likely the lesion is to develop in the direction of severity, so RF can also be used as an indicator to judge the prognosis.

I wonder what the patient's situation is like now? For rheumatism diseases, it is recommended that the method of traditional Chinese medicine "Hou's **" can be used, and the drug can be combined with physical constitution, related functional exercise, diet and psychological guidance to systematically synthesize**.

Rotten Circle Answer]: c

Rheumatoid factor is the self-anticomm lead body of the FC fragment of the IgG molecule, with a positive rate of about 80%, and can be present in serum or synovial fluid. Since rheumatoid factor is a good autoantibody, answer ab is excluded first when solving the problem.

Shed core answer] :d

Analysis: Rheumatoid factor is an autoantibody to the FC fragment of IgG molecule, and rheumatoid factor (RF) in serum can be divided into IgM and Iggiga type (C wrong D pair). The positive rate of RF for rheumatoid arthritis is 60% 78% and the specificity is 86, which are inferior to anti-cyclic citrullinated polypeptide (CCP) antibodies.

Rheumatoid factor: is an autoantibody that can distinguish between IgM type, IgG type, IgA type; It is detected as IgM type in clinical routine work, and it is seen in 70% of patients' serum, and its number is proportional to the activity and severity of the disease, but it also exists in systemic lupus erythematosus, primary Sjögren's syndrome, systemic sclerosis, acute bacterial endocarditis, chronic tuberculosis, hyperglobulinemia and other diseases, and even in 5% of normal people with moderate sensitization, low titers of rheumatoid factor can occur.

A must-read for patients with liver disease.

Patients with liver disease should pay attention to the following points when taking medication:

1) Clarify liver function and comorbidities.

2) Be fully aware of the drug used, be familiar with its indications and side effects. If adverse drug reactions occur, generally 1-4 weeks after the drug, there are many fever, rash, itching and peripheral blood changes, and some people can also have liver damage. There are also some delayed reactions (such as certain Chinese herbal medicines, etc.) that can occur after 3 months of medication.

Chen Xiao, Department of Hepatology, Beijing You'an Hospital.

3) In the case of liver disease combined with other diseases, do not copy the methods and dosage of general patients, but according to the specific situation, it varies from person to person.

4) If the aminotransferase is found to be more than 2 times higher after medication, and other reasons are excluded, the drug should be stopped or replaced with other drugs.

In addition, the medication of patients with liver disease should be simplified, and the types of medication should not be too much, because most drugs are metabolized and detoxified in the liver, and when suffering from liver disease, the metabolism and clearance of drugs are affected, so the medication should be simplified.