Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Rheumatoid factor is an antibody that is measurable in the blood. Rheumatoid
factor is actually an antibody that can bind to other antibodies.
Antibodies are normal proteins in our blood that are
important parts of our immune system. Rheumatoid factor is
an antibody that is not usually present in the normal
individual.
For what is the rheumatoid factor test used?
Rheumatoid factor is commonly used as a blood test for the diagnosis of
rheumatoid arthritis. Rheumatoid factor is present in about 80%
of adults (but a much lower proportion of children) with
rheumatoid arthritis.
Can rheumatoid factor be present in a patient without
rheumatoid arthritis?
Yes. Rheumatoid factor is also present in patients with other conditions,
including other connective tissue diseases (such as systemic
lupus erythematosus), some infectious diseases (such as
infectious hepatitis, syphilis, infectious mononucleosis,
parasites, and tuberculosis), liver disease, and
sarcoidosis. Rheumatoid factor can also sometimes be present in
normal individuals without diseases. This occurs more
frequently in people with family members who have
rheumatoid arthritis.
What significance does the rheumatoid factor hold for patients with rheumatoid
arthritis?
High levels of rheumatoid factor are associated with more severe rheumatoid
disease. This factor is also associated with a higher tendency to
develop non-joint manifestations of rheumatoid disease,
such as rheumatoid nodules and rheumatoid lung disease.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Sjögren's syndrome is an autoimmune disease involving the abnormal production of extra antibodies that attack the glands and connective tissue. Sjögren's syndrome with gland inflammation (resulting dry eyes and mouth, etc.) that is not associated with another connective tissue disease is referred to as primary Sjögren's syndrome. Sjögren's syndrome that is also associated with a connective tissue disease, such as rheumatoid arthritis, systemic lupus erythematosus, or scleroderma, is referred to as secondary Sjögren's syndrome. Though there is no cure for Sjögren's syndrome, the symptoms may be treated by using lubricating eye ointments, drinking plenty of water, humidifying the air, and using glycerin swabs. Medications are also available to treat dry eye and dry mouth.
Fibromyalgia, formerly
known as fibrositis, causes chronic pain, stiffness, and
tenderness of muscles, tendons, and joints without detectable inflammation. Fibromyalgia patients have an unusually low pain threshold. Symptoms of fibromyalgia include fatigue, abnormal sleep, mental/emotional disturbances, abdominal pain, migraine and tension headaches, and irritable bladder. Treatment of fibromyalgia involves patient education, medication, exercise, and stress reduction.
Raynaud's phenomenon is characterized by a pale-blue-red sequence of color changes of the digits, most commonly after exposure to cold. Occurring as a result of spasm of blood vessels, the cause is unknown. Symptoms of Raynaud's phenomenon depend on the severity, frequency, and duration of the blood vessel spasm. Treatments include protection of the digits, medications, and avoiding emotional stresses, smoking, cold temperature, and tools that vibrate the hands.
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves antiinflammatory medications and exercise.
Reactive arthritis is a chronic, systemic rheumatic disease characterized by three conditions, including conjunctivitis, joint inflammation, and genital, urinary or gastrointestinal system inflammation. Inflammation leads to pain, swelling, warmth, redness, and stiffness of the affected joints. Non-joint areas may experience irritation and pain. Treatment for reactive arthritis depends on which area of the body is affected. Joint inflammation is treated with antiinflammatory medications.
Juvenile arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are three types of JRA: pauciarticular (less than four joints affected), polyarticular (more than four joints affected), and systemic-onset (inflamed joints with high fevers and rash). Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
Citrulline antibody is an immune
protein (antibody) that binds to a
non-standard amino acid (citrulline) that is formed by removing amino groups
from the natural amino acid, arginine. Citrulline antibodies are measured with a
blood test that is analyzed in laboratories.
Research suggests that in the joints of patients with
rheumatoid arthritis, proteins may be changed to citrulline as part of the
process that leads to inflammation of the rheumatoid joint. Citrulline antibody has also been referred
to as anti-citrulline antibody, anti-cyclic citrullinated peptide antibody, and
anti-CCP.
For what is citrulline antibody used?
Citrulline antibody is present in the blood of most patients with rheumatoid arthritis. It is used in the diagnosis of rheumatoid arthritis when evaluating patients with unexplained joint inflammation. A test for citrulline antibodies is most helpful in looking for the cause ...
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