Rheumatoid arthritis

La Dra. Kavita Krishna, M.D., D.N.B. (Medicina Interna), es profesora de medicina en el Colegio Médico Bharati Vidyapeeth y en el Hospital Bharati, en Pune, India. Académica sincera y clínica astuta, tiene numerosas publicaciones en diversas revistas internacionales y nacionales, además de muchos proyectos de investigación en su haber.

Fifty patients of Rheumatoid arthritis were studied; 88% were females. Rheumatoid factor was positive in 90%. Raised ESR and CRP were markers of ongoing inflammation. The maximum number of patients (98%) presented with articular symptoms; 14% of had associated extra-articular symptoms; 2% presented only with extra-articular manifestations.The most common joints to be involved were the small joints of the hand, followed by the wrist, elbow, toes, hip and knee joints. The disease related complications seen commonly were various joint deformities and osteoporosis. Spine involvement in the form of atlanto-axial dislocation was seen in 2%.Extra articular complications were episcleritis and vasculitis syndrome, dryness of eyes and mouth, and rheumatoid nodules. Postpartum flare of symptoms was seen in one patient. Drug related complications were uncommon (22%); most of which were minor side effects. Antirheumatic drugs especially DMARDs like methotrexate are very much safe and have high acceptability among the patients. Regular monitoring of patients is required. DAS 28 score is very helpful in assessing the patient response on treatment with DMARDs.