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Monday, 25 November 2013

Rheumatoid Arthritis (RA) - The Complications

Rheumatoid Arthritis
Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than in men and generally occurs after the ages of 40 and diminishes the quality of life of many elders.
omplications
1. Osteoporosis.
People who develop Rheumatoid arthritis can induce the a condition that weakens your bones and makes them more prone to fracture as a result of certain medication intake. Dr Lee SG, and the research team at the Pusan National University School of Medicine, showed that the prevalence of osteoporosis in the RA patients was 1.9 times higher than in healthy subjects. Glucocorticoid use was a risk factor for generalized bone loss in female RA patients(23).
2. Carpal tunnel syndrome
Carpal tunnel syndrome is defined as a condition of pressure on the nerve in the wrist that supplies feeling and movement to parts of the hand. If affects your wrists, it can compress the nerves of  your hand and fingers. There is a report of a case of carpal tunnel syndrome caused by volar dislocation of the lunate in a patient with rheumatoid arthritis. A 74-year-old woman complained of numbness in her fingers. Carpal tunnel syndrome was diagnosed, and carpal tunnel release was performed. However, the symptoms recurred(24).
3. Heart involvement
Scientists at the University of Palermo indicated that RA resulted significantly associated to pericardial effusion (OR 10.7; 95% CI 5.0-23.0), valvular nodules (OR 12.5; 95% CI 2.8-55.4), tricuspidal valve insufficiency (OR 5.3; 95% CI 2.4-11.6), aortic valve stenosis (OR 5.2; 95% CI 1.1-24.1), mitral valve insufficiency (OR 3.4; 95% CI 1.7-6.7), aortic valve insufficiency (OR 1.7; 95% CI 1.0-2.7), combined valvular alterations (OR 4.3; 95% CI 2.3-8.0), mitral valve thickening and/or calcification (OR 5.0; 95% CI 2.0-12.7), aortic valve thickening and/or calcification (OR 4.4; 95% CI 1.1-17.4), valvular thickening and/or calcification (OR 4.8; 95% CI 2.2-10.5), and mitral valve prolapse (OR 2.2; 95% CI 1.2-4.0)(25).
4.  Interstitial lung disease (ILD)
People with rheumatoid arthritis have an increased risk of interstitial lung disease (ILD). In the study to describe the evolution of lung function in a cohort of rheumatoid arthritis (RA) patients with interstitial lung disease (ILD)found that Patients with RA and ILD may have an improvement in the FVC after a treatment with high doses of corticosteroids and disease modifying antirheumatic drugs (DMARDs)(26).
5. Dry eye syndrome and Sjogren’s syndrome 
In the evaluate the prevalence of dry eye and secondary Sjogren’s syndrome using salivary scintigraphy found that awareness and detection of dry eye syndrome and secondary Sjogren’s syndrome in rheumatoid arthritis was crucial for evaluation of their severity and proper management(27).
6. Cerebral vasculitis
There is a report of a 64-year-old woman was suffering from rheumatoid arthritis since the age of 57. At the age of 62, she manifested episcleritis of the eyes and rheumatoid nodules in the skin, and rheumatoid factor in the blood became high. These findings indicated the presence of systemic vasculitis, and she was treated with prednisolone(28).
7. Etc.

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Sources
(23) http://www.ncbi.nlm.nih.gov/pubmed/22709491
(24) http://www.ncbi.nlm.nih.gov/pubmed/17165005
(25) http://www.ncbi.nlm.nih.gov/pubmed/22703938
(26) http://www.ncbi.nlm.nih.gov/pubmed/22341526
(27) http://www.ncbi.nlm.nih.gov/pubmed/22696854
(28) http://www.ncbi.nlm.nih.gov/pubmed/9805988