Seropositive Rheumatoid Arthritis

Medically reviewed by Nancy Carteron, MD, FACR on September 28, 2017Written by Becky Young

Overview

Rheumatoid arthritis (RA) is a long-term condition that primarily affects your joints. The most common form is seropositive RA. A person with this condition has antibodies in their blood that help identify the disease. These antibodies are called anti-CCPs or rheumatoid factors (RF). Either or both of these can be present. Their presence is associated with inflammation of the joints and the onset of RA symptoms.

Those with seronegative RA don’t have these antibodies present, but still display symptoms of classic RA. Those with seropositive RA generally have more severe symptoms and greater deformities.

What are the symptoms?

RA has a particular group of symptoms that can come and go over time. People with this condition will usually test positive for rheumatoid factor within one year of developing symptoms. Anti-CCPs are more sensitive and can show up years before you display any symptoms. The symptoms specific to RA include:

  • swelling and pain in the joints, especially those of the hands and feet
  • several affected joints
  • symmetrical joints
  • stiffness in the morning lasting around 45 minutes
  • deterioration of the cartilage and bone (determined by X-rays)
  • development of firm lumps under the skin near to the joints (rheumatoid nodules)

There are some other symptoms of RA that are shared with unrelated conditions. These include:

  • a slight fever
  • frequent infections
  • constant fatigue
  • depression
  • anemia

How is RA diagnosed?

Your blood will be tested to see if anti-CCPs or rheumatoid factors are present. If the test comes back positive, there is a 70–80 percent chance of receiving an RA diagnosis. A positive result may also indicate other conditions. Therefore, testing positive is not enough for a doctor to give a full diagnosis. A full diagnosis also requires you to display the symptoms of RA. X-rays showing cartilage and bone deterioration can be helpful in reaching a full diagnosis, especially if joint damage (erosion) is present. Additional blood tests can be done to test the level of inflammation in the joints.

What is the prognosis for seropositive RA?

People with seropositive RA are likely to have more severe symptoms than those who are seronegative, though this is not true in all cases. People with seropositive RA are more likely to develop rheumatoid nodules, vasculitis, and rheumatoid lung issues. They are also at greater risk of developing associated conditions, such as cardiovascular disease.

Despite this, the progression of the disease varies greatly and is dependent upon many factors. Therefore, it’s impossible to predict a precise prognosis.

Treatment options

As there is currently no cure for seropositive RA, treatment focuses on managing pain and inflammation, and trying to prevent further damage to the joints. Traditionally, treatment for seropositive RA can include a combination of therapy, home care, medication, and surgery.

Therapy

Specialist RA therapists can help change daily habits in order to reduce stress on joints. There are special tools and devices available to assist with daily functioning while limiting any further damage to joints.

Home care

It’s recommended that those with seropositive RA exercise regularly. Exercise helps to keep your joints movable and build strength in your muscles.

If you’re experiencing a flare-up, it can help to alternate between cold and hot compresses to control the pain and inflammation.

Medication

The most commonly used kind of medication to help with seropositive RA is a disease-modifying antirheumatic drug (DMARD). These types of drugs can slow the development of RA and help to prevent further joint damage. The DMARD that many people have heard of is methotrexate.

You can also take nonsteroidal anti-inflammatory drugs such as ibuprofen to help manage pain and inflammation. Steroid medications like prednisone are also effective in managing major inflammation flares.

Surgery

When the damage to joints is extreme, surgery could be necessary. Some procedures can help improve mobility and reduce pain in severely deformed joints. Sometimes it’s necessary for the joints to be completely replaced. However, there is the potential for complications, like infections, with surgery. For this reason, surgery is only undertaken in cases where the benefits are deemed to outweigh the risks.

Complications

People with seropositive RA are at a greater risk of developing associated conditions, particularly if their condition is not well managed. Some of the conditions associated with seropositive RA are:

Outlook and when to see your doctor

As previously mentioned, there is no cure for seropositive RA, but effective management of the condition means that many people go on to enjoy a good quality of life.

You should go and see your doctor as soon as you begin to experience any of the noted symptoms of seropostive RA, as an early diagnosis will mean less damage to your joints and slower progression of the disease with medication treatment.

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