#Rheumatology_Course
#Rheumatoid Arthritis
#one_point_one_test
Rheumatoid arthritis is an autoimmune disease that can cause joint pain and damage.
Reason:
Many genes play a role in the disease of patients, the most important of which is MHC Class II, especially those who have the HLA-DR haplotype.
signs :
The most important clinical symptoms of RA are joint manifestations. These manifestations mostly occur in the small joints of the upper limbs and involve the joints of the lower limbs
It indicates that the condition of the disease is worse.
Patients complain of morning dryness that lasts more than an hour.
They have relative swelling of the joints, which is mostly seen in the wrists of both hands, PIPs, MCP and MTP. Erosion of bone and articular cartilage occurs. Joint subluxations and ulnar deviation are seen.
Swollen joint fluid is inflammatory.
They may experience symptoms of carpal tunnel syndrome.
May
Have a baker’s cyst.
Non-articulated manifestations:
Rheumatoid nodules: a series of subcutaneous nodules that can rarely occur in other places such as lungs and sclera.
May be:
• These people suffer from lung diseases.
• Have vasculitis, especially in the skin and peripheral nerves.
• Have pleural and pericardial involvement.
• Have scleritis and episcleritis.
• Have leg ulcers.
• Have Felty’s syndrome.
Diagnosis:
The diagnosis of this disease is based on signs, symptoms, laboratory findings and radiographic evidence.
RF:
It is an autoantibody that is used to diagnose RA. It is usually an IgM type that binds to the Fc part of IgG. About 70-80% of RA patients are RF positive, but some patients may be RF negative, especially in the early stages of the disease.
Anti-CCP:
Another antibody used to diagnose RA is called anti-CCP, which is more specific than RF and is more than 95
The percentage of cases may be positive. Anti-CCP positive patients have a more severe outcome in terms of radiographic changes and injuries in the joint
It happens, they have, and they also have a worse prognosis.
treatment :
1. One of the main treatments for RA patients is the use of glucocorticoids, which can be used 1- intra-articularly 2-systemically (oral and IV and IM injections).
2. Other drugs that were mostly used in the past are NSAIDs, which nowadays are less than them due to newer and more effective drugs.
is used
DMARDs are the most important drugs used to treat rheumatoid arthritis. At the top of these drugs are the following.
Hydroxychloroquine
Methotrexate
Leflunomide
Sulfasalazine
* DMARD = disease-modifying antirheumatic drugs
#Rheumatoid Arthritis
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