Rheumatoid Factor (RF)

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Test Overview

A rheumatoid factor (RF) blood test measures the amount of the RF antibody present in the blood. Normally, antibodies are produced by the immune system to help destroy and eliminate invading bacteria and viruses that can cause disease. But the RF antibody can attach to normal body tissue, resulting in damage.

A high level of rheumatoid factor can be caused by several autoimmune diseases (including rheumatoid arthritis) and some infections. Occasionally an elevated level of RF is present in healthy people.

The amount of rheumatoid factor in blood can be measured in two ways:

• Agglutination tests. One test method mixes blood with tiny rubber (latex) beads that are covered with human antibodies. If RF is present, the latex beads clump together (agglutinate). This method is best used as a first-time screening test for rheumatoid arthritis. Another agglutination test mixes the blood being tested with a sheep's red blood cells that have been covered with rabbit antibodies. If RF is present, the red blood cells clump together. This method is often used to confirm the presence of RF.
• Nephelometry test. This test mixes the blood being tested with antibodies that cause the blood to clump if RF is present. A laser light is shined on the tube containing the mixture and the amount of light blocked by the blood sample is measured. As levels of RF increase, more clumping occurs, causing a cloudier sample and less light to pass through the tube.

Last updated:	June 12, 2008
Author:	Shannon Erstad, MBA/MPH
Reviewed By:	Kathleen Romito, MD - Family Medicine, Stanford M. Shoor, MD - Rheumatology
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer