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Clinical Significance of Rheumatoid Factor in Juvenile Rheumatoid Arthritis

Journal of the Korean Pediatric Society 1992;35(5):639-645.
Published online May 15, 1992.
Clinical Significance of Rheumatoid Factor in Juvenile Rheumatoid Arthritis
Ki Joong Kim, Bo Young Yun, Joong Gon Kim
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
소아 류마티양 관절염에서 류마티양 인자의 임상적 의의
김기중, 윤보영, 김중곤
서울대학교 의과대학 소아과학교실
Abstract
Rheumatoid factor is a commonly used laboratory test by clinicians to assess the children with possible juvenile rheumatoid arthritis. To assess its diagnositc value and clinical significance we reviewed the case histories of the patients in whom latex agglutinating rheumatoid factor was tested during November 1988 to April 1991 at Seoul National University Children's Hospital. There were 61 patients with positive test for rheumatoid factor, of whom 16 had juvenile rheumatoid arthritis. A total of 813 children had negative results, of whom 63 had juvenile reheumatoid arthritis. This yields a sensitivity of 20.3% and a specificity of 94.3%. The predictive values and marginal benefits for rheumatoid factor were calculated using Bayes' theorem. Rheumatoid factor testing appeared to be of few benefit. The clinical and laboratory data were obtained from 14 patients with positive results and 48 patients with negative results to assess the clinical significance. There were no significant difference between rheumatoid factor positive and negative patients in clinical findings including age of onset, sex, type of disease, and articular and extraarticular manifestation, and laboratory findings of inflammatory indices such as WBC count, platelet count, ESR, CRP, ASO, FANA and bone X-ray. Testing for rheumatoid factor seems to be a poor screening procedure for juvenile rheumatoid arthritis in the general situation.
Key Words: Rheumatoid factor, Juvenile rheumatoid arthritis


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