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Super Advanced - Arthiritis Profile

Bone

72 parameters

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Report in 8Hrs

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Fasting Required

Details

Extended arthritis panel with autoimmune markers (ANA, anti-CCP, RF).

₹3,499₹4,560

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Parameters

  • List of Tests
    • Calcium
    • Alkaline Phosphatase
    • SGOT
    • SGPT
    • Uric Acid
    • Complement 3 (C3)
    • Anti-Streptolysin (ASO)
    • BUN, Creatinine, BUN/Creatinine
    • GGT
    • RF
    • ANA
    • Anti CCP (ACCP)
    • Iron Studies (Iron, TIBC, Transferrin)
    • Serum Bilirubin (Total, Direct, Indirect)
    • Lipid Profile (Cholesterol/HDL, LDL/HDL, Non-HDL, VLDL, Total Cholesterol, Triglycerides, HDL, LDL)
    • Total Protein, Albumin, Globulin, A/G Ratio
    • Thyroid Profile - Total T3, Total T4, TSH
    • C-Reactive Protein (CRP)
    • Hba1c, estimated Average Glucose
    • CBC - Complete Hemogram (28)
    • Phosphorous
    • Vitamin B12
    • 25 OH Vitamin D
    • Serum Electrolytes (Na, K, Cl)

Super Advanced - Arthritis Profile

  • Why is it done?
    • Comprehensive screening and diagnosis of various forms of arthritis including rheumatoid arthritis (RA), osteoarthritis, systemic lupus erythematosus (SLE), and other autoimmune joint diseases
    • Detection of inflammatory markers and autoimmune antibodies that contribute to joint inflammation and tissue damage
    • Assessment of liver and kidney function to ensure safe use of arthritis medications (NSAIDs, DMARDs, biologics)
    • Evaluation of bone metabolism and mineral status, which are critical in arthritic conditions and osteoporosis prevention
    • Monitoring for metabolic complications and comorbidities commonly associated with arthritis (thyroid disease, diabetes, dyslipidemia)
    • Baseline assessment before initiating treatment with disease-modifying antirheumatic drugs (DMARDs) or biologic therapies
    • Regular monitoring of disease activity and treatment response in patients with established arthritis
    • Investigation of joint pain, swelling, stiffness, and loss of function to differentiate between arthritic and non-arthritic causes
    • Identification of secondary complications such as anemia, nutritional deficiencies, and cardiovascular risk factors
  • Normal Range
    • Calcium: 8.5-10.2 mg/dL (2.1-2.6 mmol/L) - Normal range supports bone health and neuromuscular function
    • Alkaline Phosphatase (ALP): 30-120 U/L - Elevated in bone remodeling and liver disease; normal indicates proper bone and liver function
    • SGOT (AST): 10-40 U/L - Normal indicates adequate liver function and absence of hepatocellular damage
    • SGPT (ALT): 7-56 U/L - Normal indicates liver health; more specific for liver injury than AST
    • Uric Acid: 3.5-7.2 mg/dL (0.2-0.4 mmol/L) for females; 2.6-6.0 mg/dL (0.15-0.35 mmol/L) for males - Normal prevents gout and crystal arthropathies
    • Complement 3 (C3): 80-160 mg/dL - Normal levels indicate adequate complement system function; low levels suggest autoimmune disease activity
    • Anti-Streptolysin (ASO): <200 IU/mL - Negative or low titer indicates no recent streptococcal infection; normal rules out post-streptococcal complications
    • BUN: 7-20 mg/dL - Normal kidney function; elevated suggests renal disease or dehydration
    • Creatinine: 0.6-1.2 mg/dL - Normal indicates adequate glomerular filtration rate and kidney function
    • BUN/Creatinine Ratio: 10-20 - Normal ratio indicates appropriate renal perfusion and function
    • GGT (Gamma-Glutamyl Transferase): 0-65 U/L - Normal indicates liver and bile duct health; sensitive marker of liver dysfunction
    • Rheumatoid Factor (RF): <14 IU/mL - Negative RF has high specificity for RA; positive indicates autoimmune response
    • ANA (Antinuclear Antibody): Negative or <1:80 dilution - Negative ANA essentially rules out SLE and related autoimmune diseases
    • Anti-CCP (Anti-Cyclic Citrullinated Peptide): <20 U/mL - Negative indicates low risk of RA; positive highly specific for RA
    • Iron: 60-170 mcg/dL - Normal supports adequate oxygen transport and energy metabolism
    • TIBC (Total Iron Binding Capacity): 250-425 mcg/dL - Normal indicates adequate iron transport capacity
    • Transferrin: 200-360 mg/dL - Normal supports proper iron metabolism and transport
    • Total Bilirubin: 0.1-1.2 mg/dL - Normal indicates proper liver conjugation and excretion function
    • Direct Bilirubin: 0.0-0.3 mg/dL - Normal indicates patent bile ducts and proper liver metabolism
    • Indirect Bilirubin: 0.1-0.9 mg/dL - Normal indicates adequate hemoglobin metabolism
    • Total Cholesterol: <200 mg/dL - Optimal for cardiovascular health; important in arthritis patients with increased CV risk
    • HDL (Good Cholesterol): >40 mg/dL (males), >50 mg/dL (females) - Normal provides cardiovascular protection
    • LDL (Bad Cholesterol): <100 mg/dL - Optimal level reduces cardiovascular risk
    • Triglycerides: <150 mg/dL - Normal indicates good lipid metabolism and reduced cardiovascular risk
    • VLDL: <30 mg/dL - Normal indicates proper very low density lipoprotein metabolism
    • Total Protein: 6.0-8.3 g/dL - Normal indicates adequate nutritional status and immune function
    • Albumin: 3.5-5.5 g/dL - Normal indicates liver synthetic function and nutritional status; low albumin seen in chronic disease
    • Globulin: 2.0-3.5 g/dL - Normal indicates adequate immune protein production; elevated in autoimmune diseases
    • A/G Ratio (Albumin/Globulin): 1.0-2.5 - Normal ratio indicates balanced protein metabolism
    • TSH (Thyroid Stimulating Hormone): 0.4-4.0 mIU/L - Normal indicates proper thyroid regulation; important as thyroid disease associates with RA
    • Total T3: 80-200 ng/dL - Normal indicates adequate thyroid hormone production
    • Total T4: 4.5-12.0 mcg/dL - Normal indicates proper thyroid hormone synthesis
    • C-Reactive Protein (CRP): <3.0 mg/L - Normal indicates absence of acute inflammation; elevated correlates with arthritis activity
    • HbA1c (Hemoglobin A1c): <5.7% - Normal indicates good blood sugar control; important as diabetes associates with arthritis and medication side effects
    • Estimated Average Glucose: <100 mg/dL - Normal indicates proper glucose metabolism
    • Hemoglobin: 12.0-16.0 g/dL (females), 13.5-17.5 g/dL (males) - Normal indicates adequate oxygen-carrying capacity; anemia common in chronic arthritis
    • Hematocrit: 36-46% (females), 41-53% (males) - Normal indicates adequate red blood cell production
    • White Blood Cell Count (WBC): 4.5-11.0 x10^3/mcL - Normal indicates intact immune function; elevated in infection or inflammation
    • Platelet Count: 150-400 x10^3/mcL - Normal indicates adequate hemostasis; low counts may indicate autoimmune thrombocytopenia in SLE
    • Phosphorous: 2.5-4.5 mg/dL - Normal supports bone metabolism and cellular function
    • Vitamin B12: 200-900 pg/mL - Normal indicates adequate neurological function and red blood cell formation
    • 25-OH Vitamin D: 30-100 ng/mL - Normal indicates adequate vitamin D for bone health and immune regulation; critical in arthritis management
    • Sodium (Na): 135-145 mEq/L - Normal indicates proper fluid and electrolyte balance
    • Potassium (K): 3.5-5.0 mEq/L - Normal indicates proper cardiac and neuromuscular function
    • Chloride (Cl): 98-107 mEq/L - Normal indicates proper fluid balance and acid-base status
  • Interpretation
    • Calcium: Elevated levels (>10.2 mg/dL) may indicate hypercalcemia from vitamin D toxicity or malignancy; low levels (<8.5 mg/dL) suggest hypoparathyroidism or vitamin D deficiency affecting bone quality
    • Alkaline Phosphatase: Elevated (>120 U/L) indicates active bone remodeling, liver disease, or bone metastases; decreased (<30 U/L) may suggest hypophosphatasia or malnutrition
    • SGOT (AST): Elevated (>40 U/L) indicates hepatocellular injury, muscle damage, or hemolysis; non-specific marker for liver disease
    • SGPT (ALT): Elevated (>56 U/L) indicates hepatocellular damage from medication (methotrexate, NSAIDs), viral hepatitis, or fatty liver disease; more liver-specific than AST
    • Uric Acid: Elevated (>7.2 mg/dL in females, >6.0 mg/dL in males) causes gout and monosodium urate crystal arthritis; low levels rare but may indicate xanthine oxidase deficiency
    • Complement 3 (C3): Low levels (<80 mg/dL) indicate active autoimmune disease, particularly SLE with nephritis; normal levels in most RA cases unless concurrent SLE
    • Anti-Streptolysin (ASO): Elevated titer (>200 IU/mL) indicates recent streptococcal infection; may trigger acute rheumatic fever or post-streptococcal reactive arthritis
    • BUN: Elevated (>20 mg/dL) suggests renal disease, dehydration, or may indicate acute kidney injury from NSAIDs; low levels (<7 mg/dL) indicate liver disease or malnutrition
    • Creatinine: Elevated (>1.2 mg/dL) indicates reduced glomerular filtration rate and kidney disease, critical concern for DMARD dosing; low values may indicate reduced muscle mass
    • BUN/Creatinine Ratio: >20 suggests prerenal azotemia (dehydration, heart failure); <10 may indicate liver disease or malnutrition
    • GGT: Elevated (>65 U/L) indicates liver disease, alcohol use, or medication toxicity; often elevated with methotrexate use
    • Rheumatoid Factor (RF): Positive (>14 IU/mL) in 70-80% of RA patients; can be positive in other autoimmune diseases; seropositivity associated with worse prognosis and joint erosion
    • ANA: Positive (≥1:80) suggests autoimmune disease; specific pattern (homogeneous, speckled, centromere, nucleolar) helps differentiate SLE, Sjögren's, scleroderma; negative ANA essentially excludes SLE
    • Anti-CCP: Positive (>20 U/mL) highly specific for RA (98% specificity); present before RF; better predictor of erosive disease than RF; may precede symptom onset
    • Iron: Elevated (>170 mcg/dL) causes hemochromatosis increasing arthritis risk (especially affecting MCPs); low (<60 mcg/dL) indicates iron deficiency anemia common in chronic arthritis
    • TIBC: Elevated (>425 mcg/dL) indicates iron deficiency; low (<250 mcg/dL) suggests iron overload or chronic disease
    • Transferrin: Elevated (>360 mg/dL) indicates iron deficiency; low (<200 mg/dL) suggests iron overload or inflammation
    • Total Bilirubin: Elevated (>1.2 mg/dL) indicates liver dysfunction, hemolysis, or biliary obstruction; may be elevated with methotrexate toxicity
    • Direct Bilirubin: Elevated (>0.3 mg/dL) indicates cholestasis or hepatic injury requiring investigation
    • Indirect Bilirubin: Elevated (>0.9 mg/dL) indicates hemolysis or ineffective erythropoiesis; common in autoimmune hemolytic anemia associated with SLE
    • Total Cholesterol: Elevated (>200 mg/dL) increases cardiovascular risk, especially important in RA patients with increased CV mortality
    • HDL: Low (<40 mg/dL in males, <50 mg/dL in females) increases CV risk; protective factor against atherosclerosis
    • LDL: Elevated (>100 mg/dL) increases CV risk; goal <100 mg/dL, or <70 mg/dL in patients with established CV disease
    • Triglycerides: Elevated (>150 mg/dL) increases CV risk and may indicate metabolic syndrome; inflammation increases triglycerides in arthritis
    • VLDL: Elevated (>30 mg/dL) contributes to CV risk; calculated from triglycerides (TG/5)
    • Total Protein: Low (<6.0 g/dL) indicates malnutrition, liver disease, or protein-losing conditions; elevated (>8.3 g/dL) suggests chronic inflammation or dehydration
    • Albumin: Low (<3.5 g/dL) indicates chronic disease, liver dysfunction, malnutrition, or nephrotic syndrome; reflects disease severity and nutritional status in arthritis
    • Globulin: Elevated (>3.5 g/dL) indicates chronic inflammation, autoimmune disease, or infection; very high elevations suggest multiple myeloma
    • A/G Ratio: Low (<1.0) indicates relative increase in globulins suggesting inflammation; high (>2.5) suggests albumin elevation or globulin reduction
    • TSH: Elevated (>4.0 mIU/L) indicates hypothyroidism common in autoimmune arthritis; low (<0.4 mIU/L) suggests hyperthyroidism or overtreatment
    • Total T3: Elevated indicates hyperthyroidism; low indicates hypothyroidism or illness; less specific than TSH alone
    • Total T4: Elevated indicates hyperthyroidism; low indicates hypothyroidism; used with TSH for thyroid assessment
    • C-Reactive Protein (CRP): Elevated (>3.0 mg/L) indicates active inflammation; directly correlates with RA disease activity and erosive disease; used for disease monitoring
    • HbA1c: 5.7-6.4% indicates prediabetes; ≥6.5% indicates diabetes; important as inflammation increases diabetes risk and NSAIDs affect glucose control
    • Estimated Average Glucose: 100-125 mg/dL indicates prediabetes; >126 mg/dL indicates diabetes management needed
    • Hemoglobin: Low (<12.0 g/dL females, <13.5 g/dL males) indicates anemia of chronic disease common in RA; elevated suggests polycythemia or dehydration
    • Hematocrit: Low (<36% females, <41% males) indicates anemia; elevated suggests dehydration or polycythemia
    • WBC: Elevated (>11.0 x10^3/mcL) indicates infection or leukemia; low (<4.5 x10^3/mcL) suggests immunosuppression from medications or bone marrow disease
    • Platelet Count: Low (<150 x10^3/mcL) may indicate immune thrombocytopenia in SLE or medication toxicity; elevated (>400 x10^3/mcL) suggests reactive thrombocytosis
    • Phosphorous: Low (<2.5 mg/dL) indicates hypophosphatemia from renal disease or malabsorption; high (>4.5 mg/dL) suggests kidney disease
    • Vitamin B12: Low (<200 pg/mL) indicates deficiency causing neuropathy and fatigue; may occur with malabsorption in celiac disease associated with arthritis
    • 25-OH Vitamin D: 20-29 ng/mL indicates insufficiency; <20 ng/mL indicates deficiency increasing inflammation and bone loss; optimal >30 ng/mL for arthritis management
    • Sodium: Low (<135 mEq/L) causes hyponatremia from SIADH in autoimmune diseases; high (>145 mEq/L) indicates dehydration
    • Potassium: Low (<3.5 mEq/L) causes hypokalemia from diuretics or diarrhea; high (>5.0 mEq/L) indicates hyperkalemia from kidney disease or medication
    • Chloride: Low (<98 mEq/L) indicates hypochloremia from vomiting or diuretics; high (>107 mEq/L) suggests dehydration or metabolic acidosis
  • Associated Organs
    • Calcium and Phosphorous: Primarily assess skeletal system and parathyroid function; abnormalities lead to osteoporosis, fractures, and metabolic bone disease common in arthritis patients
    • Alkaline Phosphatase, ALP, and Bilirubin: Evaluate liver function and bile duct patency; critical for monitoring patients on methotrexate, which causes hepatotoxicity
    • SGOT (AST) and SGPT (ALT): Markers of hepatocellular injury; SGPT more specific for liver; indicate safety of methotrexate, leflunomide, and biologic therapy
    • GGT: Sensitive but non-specific liver enzyme; elevated in alcoholic liver disease and cholestasis; important for DMARD monitoring
    • Uric Acid: Produced by kidneys and influenced by purine metabolism; crystal deposition in joints causes gout; kidney dysfunction affects clearance
    • Complement 3 (C3): Component of immune system produced in liver; consumed in autoimmune diseases; low levels indicate SLE activity and immune complex deposition
    • Anti-Streptolysin (ASO): Produced by immune system in response to group A streptococcal infection; elevation links to post-streptococcal reactive arthritis and acute rheumatic fever
    • BUN and Creatinine: Primary markers of kidney (renal) function; critical for assessing glomerular filtration rate and adjusting DMARD doses
    • Rheumatoid Factor (RF): Autoantibody produced by immune system; indicates active humoral immune response in RA affecting multiple joints
    • ANA (Antinuclear Antibody): Autoantibody targeting nuclear antigens; produced by immune system; diagnostic for SLE and related connective tissue diseases affecting joints and multiple organs
    • Anti-CCP (Anti-Cyclic Citrullinated Peptide): Autoantibody specific for RA; produced by B cells in joints; directly involved in joint damage pathogenesis
    • Iron Studies: Assess bone marrow iron stores and erythropoiesis; iron overload (hemochromatosis) causes arthropathy; deficiency causes anemia common in RA
    • Lipid Profile: Assesses cardiovascular risk; inflammation in arthritis elevates lipids; critical monitoring given increased CV mortality in RA patients
    • Total Protein and Albumin: Hepatic synthesis markers; reflects liver synthetic function and nutritional status; albumin low in chronic inflammation
    • Globulin: Immunoglobulin production by immune system; elevated in autoimmune arthritis indicating active B cell response
    • Thyroid Profile: Assesses thyroid gland function (hypothalamic-pituitary-thyroid axis); autoimmune thyroiditis commonly coexists with RA
    • C-Reactive Protein (CRP): Acute phase reactant produced by liver; rises with inflammation; directly correlates with systemic inflammation and joint damage in arthritis
    • HbA1c and Glucose: Assess pancreatic beta cell function and glucose homeostasis; screen for diabetes, which is common comorbidity in arthritis
    • Complete Blood Count (CBC): Evaluates bone marrow function; detects anemia of chronic disease, thrombocytopenia in SLE, and leukopenia from immunosuppressive therapy
    • Vitamin B12: Absorped in terminal ileum; methylates neurons and red blood cells; deficiency causes neuropathy and anemia; malabsorption occurs with celiac disease
    • Vitamin D: Synthesized in skin and kidney; regulates calcium absorption and immune tolerance; deficiency worsens arthritis and bone loss
    • Electrolytes (Na, K, Cl): Regulated by kidneys; abnormalities affect cardiac rhythm, neuromuscular function, and indicate kidney disease
  • Follow-up Tests
    • If elevated Calcium/Low Calcium: DEXA scan for bone density assessment; parathyroid hormone (PTH) level; ionized calcium measurement
    • If elevated Alkaline Phosphatase: Alkaline phosphatase isoenzymes to differentiate bone vs liver origin; liver ultrasound if suspected biliary obstruction
    • If elevated SGOT/SGPT: Hepatitis A, B, C serologies; liver ultrasound or CT; consider methotrexate or NSAID toxicity; repeat testing in 4-8 weeks
    • If elevated Uric Acid: 24-hour urine uric acid; urate-lowering therapy initiation; renal ultrasound to assess for tophi
    • If low C3/C4: Lupus serologies (anti-dsDNA, anti-Smith); urinalysis and 24-hour urine protein; renal biopsy if lupus nephritis suspected
    • If elevated ASO: Echocardiogram to assess for valvular disease; throat culture; repeat ASO in 2 weeks to confirm acute infection
    • If elevated Creatinine/BUN: Urine creatinine and protein quantification; renal ultrasound; glomerular filtration rate (GFR) calculation; consider kidney disease progression
    • If elevated GGT: Liver imaging; acetaminophen level if toxicity suspected; consider alcohol use counseling
    • If positive RF: Anti-CCP antibody confirmation; ESR measurement; imaging of hands and feet to assess for erosions
    • If positive ANA: Antinuclear antibody pattern reflex testing (anti-dsDNA, anti-Smith, anti-RNP, anti-Ro, anti-La); complement levels; urinalysis
    • If positive Anti-CCP: RF confirmation; MRI of hands for early erosions; baseline radiographs for comparison; aggressive therapy initiation recommended
    • If abnormal Iron Studies: Serum ferritin; iron saturation percentage; genetic testing for hemochromatosis (HFE) mutations if iron overload detected
    • If abnormal Lipid Profile: Repeat fasting lipid panel; statin therapy evaluation; nutrition consultation; repeat testing every 6-12 months
    • If low Albumin: Nutritional assessment; 24-hour urine protein if nephrotic syndrome suspected; prealbumin level for nutritional status; dietary supplementation
    • If elevated Globulin: Serum protein electrophoresis; immunofixation electrophoresis if monoclonal spike identified; investigate for multiple myeloma if marked elevation
    • If abnormal Thyroid Profile: Free T3, Free T4 levels; thyroid peroxidase (TPO) and thyroglobulin antibodies; endocrinology referral if indicated
    • If elevated CRP: ESR measurement for comparison; imaging of affected joints; disease activity assessment; consider DMARD intensification
    • If elevated HbA1c: Fasting glucose; 2-hour postprandial glucose; random glucose; consider diabetes referral; repeat HbA1c every 3 months until controlled
    • If abnormal CBC: Peripheral blood smear; reticulocyte count; folate and B12 levels if anemia; hematology referral if severe cytopenias
    • If low Vitamin B12: Methylmalonic acid and homocysteine levels; intrinsic factor antibodies; Schilling test if malabsorption suspected
    • If low Vitamin D: Repeat 25-OH Vitamin D after supplementation; parathyroid hormone level if hypocalcemia present; bone density assessment
    • If abnormal Electrolytes: Repeat serum electrolytes; urinary electrolytes if abnormality persistent; assess fluid intake and diuretic use
    • General monitoring schedule: Repeat arthritis profile every 4-8 weeks when initiating or adjusting DMARDs; every 3 months once stable; every 6-12 months for maintenance therapy
    • ESR (Erythrocyte Sedimentation Rate): Complementary acute phase reactant to CRP; often ordered with CRP for inflammation assessment and disease monitoring
    • Imaging studies: X-rays of hands/feet for baseline erosion assessment; MRI or ultrasound for joint inflammation; CT or ultrasound for organ involvement
  • Fasting Required?
    • Yes, fasting is required for this test package - minimum 8-12 hours overnight fast
    • Lipid Panel tests (Total Cholesterol, HDL, LDL, Triglycerides, VLDL) require fasting as food intake significantly affects lipid values, particularly triglycerides
    • Blood glucose and HbA1c are more accurate after overnight fasting; fasting glucose provides baseline for diabetes assessment
    • Iron studies require fasting as morning iron levels are more reproducible and meals affect iron absorption
    • Patients should avoid all food and beverages except water from midnight until blood collection (typically 6-8 AM)
    • Plain water may be consumed freely during the fasting period as it does not affect test results
    • Medications should be taken as directed unless specifically instructed otherwise by the physician; most routine medications do not require fasting
    • However, specific medications to discuss with healthcare provider before testing: NSAIDs (may affect liver enzymes and renal function), corticosteroids (affect glucose and lipids), methotrexate (requires monitoring of liver/kidney function)
    • Biologic DMARDs and conventional DMARDs should be continued as prescribed unless instructed otherwise
    • Avoid strenuous exercise 24 hours before testing as physical activity can elevate inflammatory markers and certain enzymes
    • Avoid alcohol consumption 24-48 hours before testing as it affects liver enzymes, lipids, and glucose levels
    • Limit caffeine intake 2-4 hours before testing; excessive caffeine may elevate stress hormones affecting some values
    • Ensure adequate sleep (7-9 hours) night before testing as sleep deprivation affects inflammatory markers and glucose metabolism
    • Be well-hydrated before the test but avoid excessive fluid intake immediately before blood draw
    • Inform healthcare provider of any acute illness, fever, or infection within the past 2 weeks as these affect inflammatory markers and immune tests
    • Schedule testing in the morning (ideally 6-8 AM) when most biochemical values are most stable and consistent
    • Wear loose-fitting sleeves or clothing that can be easily rolled up for blood draw access
    • For patients on anticoagulation therapy: inform phlebotomist as special precautions may be needed for blood collection
    • Blood draw typically requires one venipuncture; multiple collection tubes will be filled for various individual tests in the package
    • Results are typically available within 24-48 hours depending on laboratory processing; some specialized tests may take 5-7 business days

How our test process works!

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