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Rheumatoid factor and lyme diagnosis

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Posted 4/2/2015 2:51 AM (GMT 0)
So I will give a brief history. I am 24 and was bitten by two deer ticks within three weeks of each other in may and June and got sick in July. I got a fever, aches, sever stiffness and tightness in my hands (couldn't even flatten my hands for a good four months after much physical therapy), and inflammation in most joints. Standard lyme symptoms and cdc positive lyme test. Took the month of antibiotics and soon my symptoms came back. So about a month after the antibiotics I went to a llnd and a couple months later went to an id doctor because it was totally covered by insurance. We tried iv rocephin but only got 10 days in when I had a very bad reaction and had to go to the hospital for 4 days. So they switched me to a low dose of doxy for two months which I did along with the natural products I use. I'm pretty much done going to her now and may have the money to go to a llmd for more antibiotics if I choose to go that route because I finally feel well enough to take some part time jobs I was offered.

When I first went to the id doc she tested me for anything that may be causing my symptoms and everything was normal. One thing she tested me for was rheumatoid factor for rheumatoid arthritis and it came completely normal, right in the middle of the normal range. But they just tested it a second time because they said that sometimes it takes a little while to show up when you get it. Now my rheumatoid factor says <20 which is right at the top very top of the normal range the blood test listed and means that it has gone up quite a bit from what it was in November. I was just reading the result from the internet so it was a little confusing. I can't remember right now what the exact number was in November. I will have to try to find it but I think it was about 9. My physical therapist said that sometimes a disease like lyme can cause your immune system to active something like arthritis. My father has developed all of the standard rheumatoid arthritis symptoms over the past five years as he has gotten older so I am wondering if I was predisposed for it already and could that be causing my symptoms. I really hope not because at least Lyme disease can go away. Does anyone know if lyme can affect the rheumatoid factor and make it go up? I am still in the normal range but barely and it has risen significantly and now I'm just worried that I'm treating the wrong thing or will have arthritis the rest of my life. I did have a positive lyme test and rash at the site of a tick bite and everything. Before the lyme I had no joint problems whatsoever.

Post Edited (Green33) : 4/2/2015 5:35:52 PM (GMT-6)

Posted 4/2/2015 4:33 PM (GMT 0)
Thank you for the link. I didn't read the whole thing because honestly it is way to long for me to finish but i saw the part about them bringing about remission to RA with antibiotics. That is interesting. there is no doubt in my mind that the LD would have caused this if I have it (still don't know and don't want to think that way since my numbers are still in the normal range) but I am wondering if you treat the LD will RA that is caused by lyme go away? I sent a message to both of the lyme doctors I have been to and am trying to make an appointment with a llmd and have one with a llnd already. I was prescribed plaquinel and I am probably going to start that soon. Hoping it helps. Thinking about adding antibiotics as well. Ive been not wanting to go that route because all I have experience with is doxycycline 100mg 2x a day and that makes me very nauseous. I don't know how I would be able to take long term higher doses of antibiotics but I want to try.
Posted 4/2/2015 4:48 PM (GMT 0)
Yeah My RA factor was like yours and i know it was due to the Lyme.
Posted 4/2/2015 6:43 PM (GMT 0)
I now believe I overreacted possibly and just read it wrong. I really hope so. It seems this blood test result is laid out different than the last and it may not be 20 it may just mean that the score is less than 20 but not have a specific number listed which means it probably didn't change. I'm really hoping. I messaged the doctor for clarification.
Posted 1/5/2016 10:41 PM (GMT 0)
Wanna bump this because it's relevant.

My fiancee has had migrating joint pains for the past month or so (wrist, shoulder, lower back). She went to the doctor to get bloodwork done and the Lyme test came back negative (though I will be pushing her to have work done through IgeneX, since mine was also negative through standard lab testing) but her rheumatoid factor was 40.

Does anyone have thoughts on whether Lyme can cause a high Rheumatoid Factor?
Posted 1/5/2016 11:25 PM (GMT 0)
Lyme Arthritis vs Rheumatoid Arthritis vs Reactive Arthritis

In Lyme arthritis, the classic pattern is an inflammatory joint disease of the knee, chronically. The knee is swollen, red, and stiff, though not very painful. The knee can be so swollen that patients can't pull their knee in. There is a big effusion (fluid in the knee joint) and when it is aspirated (the fluid removed with a needle), the fluid re-accumulates rapidly. You can take 80 cc out of a Lyme-diseased knee, and three days later, there is 135 cc. The re-accumulation is very rapid, much like reactive arthritis. There are times when one confuses reactive arthritis with Lyme arthritis.

The way the diagnosis of Lyme arthritis is made is first from a full history, to exclude the other features of reactive arthritis and to include risk factors such as residence. If there was a prior diagnosis of Lyme disease, one can then go ahead and do blood tests, ELISA and Western blot or do Western blot on the synovial (joint) fluid. One can look for concentration of antibodies within the synovial fluid compared with the serum. If one finds a high level of antibodies against the organism in the synovial fluid, then I think one can make the diagnosis of Lyme disease/Lyme arthritis with confidence.

The treatment for that is oral antibiotics for four to six weeks. If people do not respond, then the next step would be intravenous antibiotics, using ceftriaxone or cefotaxime for four weeks. The durations are not well established on the basis of double blind placebo controlled studies.

I have seen two patients with a bilaterally symmetric inflammatory joint disease affecting the small joints in the hand, looking like rheumatoid arthritis, who, in fact, had Lyme arthritis. It is not a common pattern, and I think that one is reasonably assured that if one sees what looks like rheumatoid arthritis, it probably is rheumatoid arthritis. Lyme disease patients do not usually have positive findings on blood tests used to diagnose rheumatoid arthritis; that is, they are usually negative for ANA and rheumatoid factor. The sedimentation rates (a measure of inflammation) are typically not all that high in Lyme arthritis. If one sees somebody with bilaterally symmetric inflammatory joint disease and an ELISA that is positive and a Western blot that is negative and a rheumatoid factor at 1:160, I think that is rheumatoid arthritis.

https://www.hss.edu/conditions_update-on-lyme-disease.asp

This is all I have found on it. I am very arthritic but it is not rheumatoid.
Posted 1/6/2016 3:33 AM (GMT 0)
I don't know if it can cause a high rheumatoid factor but my number was way up when I was originally testing negative for Lyme. I had migrating joint pain which then after almost 2 years of misdiagnosis became constant hand and foot arthritis. All the doctors I went to (who clearly knew nothing about Lyme) all diagnosed me with RA. It never felt right to me and fortunately I followed my intuition. Finally one wise doc did an IGenex test and I was mildly positive. I began treatment and low and behold things got better and the pain went away. My RA factor has continued to decline although it is still on the high end of normal now. I ask my LLMD about it often and his take is that I have the genes for it (it's also in my family) but he believes - as I do - that it will continue to decline into normal range as I conclude treatment. That has been his experience. And now I know to be careful in the future because in fact I'm susceptible to it but I do not "have it." No more symptoms. My advice would be - don't stop at the RA diagnosis. Get the IGenex test. Good luck!!

Post Edited (GreenBlue) : 1/5/2016 8:41:06 PM (GMT-7)

Posted 1/6/2016 4:30 AM (GMT 0)
My factor was way up too. They sent me to rhuemotlogist who thought there was infectious cause ..boy was he right..glad he did not steroid me...he did great auto immune workup to humor me..said cracking paind and muscle wasting was not ra ...though my friend did cure their ra with a year of minocycline. ..coincidence.i think not...osp shed in cartilage marrow etc, the body send immune inflamation response and bam autoimmune... looking at curcumin to shut off cytokine storm
Posted 1/6/2016 5:28 PM (GMT 0)
Thanks for sharing your stories. She got her titer back from a standard lab yesterday, which showed her to be negative for Lyme. However, all of us know that those results aren't worth the paper they were printed on. I will make sure she gets tested through IGeneX.
Posted 1/6/2016 5:43 PM (GMT 0)
These tests like the rheumatoid factor will come back high if there is joint involvement with Lyme, because they are looking for inflammation and Lyme is an inflammatory infection. Of course you do want to try to rule out RA, but untreated Lyme can lead to things like RA. Treat the Lyme and the RA goes away and stays away unless there is a relapse of the Lyme.

The Moderator that was here before me (Cajungrl) has to step down because Lyme had set of RA for her.
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