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Geisinger Medical Laboratories Test Catalog
RHEUMATOID ARTHRITIS DIAGNOSTIC IDENTRA® PANEL 4 |
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ORDERING INFORMATION: |
Geisinger Epic Procedure Code: LAB1339 Geisinger Epic ID: 53281 | |
SPECIMEN COLLECTION |
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Specimen type: |
Serum | |
Preferred collection container: |
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Specimen required: |
5.8 mL serum; minimum 2.9 mL | |
Special notes: |
Do not collect in serum separator tube. | |
| SPECIMEN PROCESSING |
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Specimen processing instructions: |
Centrifuge and aliquot. | |
Transport temperature: |
Refrigerated (cold packs). | |
Specimen stability: |
Room temperature: 4 days. Refrigerated: 7 days. Frozen: 21 days. | |
Rejection criteria: |
See individual assays • Serum separator tube (SST®). | |
TEST DETAILS |
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CPT code(s): |
86200, 86235 (x2), 83520 (x4) | |
| Note: The billing party has sole responsibility for CPT coding. Any questions regarding coding should be directed to the payer being billed. The CPT codes provided by GML are based on AMA guidelines and are for informational purposes only. | ||
Test includes: |
Rheumatoid Factor (IgA, IgG, IgM), Cyclic Citrullinated Peptide (CCP) Antibody (IgG), Sjögren's Antibodies (SS-A, SS-B), 14-3-3 eta Protein | |
Methodology: |
See individual member listings. |
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Synonyms: |
Quest test code 92812, RA Diag Pnl4
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Clinical significance: |
RF is present in 75% of adult RA patients with the highest incidence of RF occurring in persons over 65 years of age. Increased RF levels may also accompany a variety of acute immune responses, particularly viral infections and a number of other diseases (infectious mononucleosis, tuberculosis, leprosy, various parasitic diseases, liver disease, sarcoidosis and systemic lupus erythematosus). Recently, it has become apparent that the specificity and predictive value of the RF test is substantially increased by the detection of all three RF isotypes. Studies suggest that the detection of RF IgA in early disease indicates poor prognosis and justifies a more aggressive course of treatment. In addition to RF IgM, raised levels of RF IgA and IgG have been reported in patients with RA. Anti-SS-A/SS-B antibodies can be detected in about 6% of patients affected by RA. These patients present a peculiar clinical picture characterized by extra-articular manifestations some of which are known to be Sjogren's Ab correlated. Early diagnosis of rheumatoid arthritis (RA), i.e., diagnosis before significant joint erosion occurs, is difficult. Psoriatic arthritis can also be difficult to diagnose clinically early in the disease process, and there are no specific biomarkers. The 14-3-3eta protein is an emerging biomarker for RA and erosive psoriatic arthritis diagnosis. It may play a biologic role in the joint erosive process. Blood levels appear to be elevated in patients with RA, but not in other diseases including psoriasis, osteoporosis, gout, ulcerative colitis, type 1 diabetes, systemic lupus erythematosus, Crohn disease, primary Sjogren syndrome, scleroderma, and multiple sclerosis. The 14-3-3eta protein, used in conjunction with rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibody, may improve diagnostic sensitivity in the early diagnosis of RA. It may also help differentiate those psoriasis patients with psoriatic arthritis erosive joint damage from those without joint damage | |