Hb 111 g/L
MCV 90 fL
WBC 9 x 10 9/L
Platelets 250 x 10 9/L
15 mm/hr (Normal)
6 mg/L (Normal)
Urine dipstick tests for blood/protein/glucose
Anti-cyclic citrullinated peptide (anti-CCP) antibodies
not in primary care
not indicated as symptoms not suggestive of connective tissue disease at this stage
The results of Kim's investigations show that she has normal inflammatory markers and negative rheumatoid factor although her history is suggestive of an inflammatory arthritis.
A normocytic anaemia is a common finding in inflammatory arthritis. Kim's case highlights the limitations of investigations in ruling inflammatory arthritis in or out. Negative blood tests can falsely reassure clinicians and patients causing delays in referral, diagnosis and initiation of disease-modifying treatment.
Back to Case study – Kim