The case are the Anti-CCp autoantibody test

The Rheumatoid factor tests is essentially a blood test which can detect the autoantibodies these are what attack the patients healthy tissues because the body thinks they are foreign (Labtestsonline.org.uk, 2018) .Normal values for the test are lower than <15 IU/m the Patients results are 256 IU/m which is a positive test value however the this test alone does not define the autoimmune disease because there is another condition called Sjogren's syndrome which can contain these antibodies. The screening is not specific because once again the antibody presence can also indicate other conditions. If this test is negative then this does not mean that either condition is still not present. According to Lab tests  (Labtestsonline.org.uk, 2018) "70-90% of patients with RA have positive RF test " this data is then a positive predictive they also stated "A negative RF test does not exclude RA or Sjögren's syndrome. About 20% of patients with RA or Sjögren's syndrome will be persistently negative or have low levels of RF" this means that neither this test alone can define whether a person does or does not have RA.Thus test is sensitive but not very specific this is why we must include several other tests to provide a clear positive diagnostic.The other tests in this patients case are the Anti-CCp autoantibody test and C-reactive protein (CRP).The Anti-CCP antibody test stands for Cyclic Citrullinated Peptide Antibody test this essentially detects anti citrulline antibodies, Citrulline is an amino acid that is a differentiated form of arginine.This test involves a blood sample  (Labtestsonline.org.uk, 2018). CCP antibodies also detect the presence of RA so if present this is another positive in terms of diagnostic normally 50-60% of patients with early RA are detected early due to this crucial antibody (Rheumatology.org. (2018).This test can be used to distinguish whether a patient has RA , so if the first test is positive and so is the second test then there is a strong probability the patient has RA if this CCP test is positive this can mean that there are some underlying pre condition symptoms essentially this means the autoimmune disease is in a early stage which is much more easy to cure. This test is highly sensitive and specific. C-Reactive Protein is a test to see the level of inflammation within the body this is a well known common symptom of RA , the protein reacts differently with inflammation , this protein is released via the liver when there is internal injury.This test is not specific it is not a screening test it just allows clinicians to see the level of protein in the blood which reacts to the level of inflammation or infection within the body.A high level of this protein is found within the patient this can suggest that there is some infection or inflammation internally alongside further testing and MRI scan of the joints, there can be a clinical diagnosis. This test is particularly significant because it tests inflammation.The clinical significance of these tests overall is extremely important because there is no direct screening test involved in RA which means that the only way to form a proper educated diagnosis is via combing many different tests that link along with the symptoms of RA after a clinician or rheumatologist is happy with the patients results then a diagnosis can be made. The test I have chosen is the C reactive protein test this is again testing the blood for protein released by the liver , the liver releases a protein when there is a internal infection or if there is inflammation . The underlying principle of this test is latex agglutination . This technique is where latex particles are mixed with part of the c reactive protein you can then see a visual agglutination.The first step of the procedure works by mixing the serum and two controls ontol a glass slide then the CRP latex is added to each of the small sections of the slide when it is all in the circles you must mix it and spread the fluid over the entire cell. For 2 minutes you should tilt the slide backwards and forwards when this is done you should observe this (Aryal, 2018). When the test is positive the circle should contain agglutination of latex particles. Another test that a Biomedical Scientist should carry out is a   ESR (erythrocyte sedimentation rate) test this allows clinicians to see the elevated erythrocyte levels , erythrocyte levels increase when there is inflammation so essentially it is a marker as is C reactive protein test. Other tests use to monitor long term complications are kidney function tests and liver function tests, these are required because of the medication that is given to some RA patients can be fatal for the kidneys because they excrete this we need to make sure the dosage is right.In the liver the drug is broken down so clinicians need to make sure that it is properly absorbed and broken because it will affect liver health.Some clinicians also do ask for a full blood count regularly so that they can ,monitor the haemoglobin levels because a low blood count can indicate a variety of things such as anemia,internal bleeding,shortage in vitamins and even a shortage in iron so these must be strictly regulated.