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McMahon et al., 2017

Canapp SO Jr, Farese JP, Schultz GS, Gowda S, Ishak AM, Swaim SF, Vangilder J, Lee-Ambrose L, Martin FG

Although most patients with confirmed RA have an abnormal test for RF and/ or ACPA, about 15%20% of cases do not have the elevated levels of RF and ACPA [4]