Rheumatoid Arthritis

Multisystem Processes & Disorders


Clinicals - History

Fact Explanation
{"ops":[{"insert":"Introduction"},{"insert":"\n"}]}
{"ops":[{"insert":"Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease of the joints that is of unknown etiology.\n\nGenetically susceptible individuals experience dysregulation of both innate and adaptive immunity. This results in the aberrant persistence of inflammatory cyokines and therefore, chronic inflammation. In addition, these individuals also develop autoimmunity against the synovial lining of the joints, bursae and tendon sheath.\n\nThe combined effects of both of the above mechanisms results in synovitis, synovial proliferation, and destruction of cartilage and subchondral bone."}]}
{"ops":[{"insert":"Persistent symmetric polyarthritis and joint stiffness"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients may experience joint swelling, and stiffness for a prolonged period (\u003E1 hour) upon waking. Multiple large (usually 2-10) and small joints (usually 4-10) may be involved, typically in a symmetric pattern."}]}
{"ops":[{"insert":"Constitutional symptoms"},{"insert":"\n"}]}
{"ops":[{"insert":"Fever and fatigability may occur. This is due to the systemic inflammatory response driven by inflammatory cytokines (e.g. TNF-alpha, Il-1 and IL-6)\n\nCognitive impairement and anemia may also occur. This is due to the inflammation affecting the brain, liver and bone marrow."}]}
{"ops":[{"insert":"Risk factor: smoking"},{"insert":"\n"}]}
{"ops":[{"insert":"Smoking increases the risk of developing RA by contributing to the formation of citrullinated proteins."}]}
{"ops":[{"insert":"Risk factor: female gender"},{"insert":"\n"}]}
{"ops":[{"insert":"Females are at a higher risk of developing RA. However, the use of oral contraceptive pills is protective against RA."}]}
{"ops":[{"insert":"Risk factor: genetic susceptibility"},{"insert":"\n"}]}
{"ops":[{"insert":"The presence of the heterozygotic allele HLA DRB1*0401\/*0404 confers an increased risk of developing RA."}]}
{"ops":[{"insert":"Risk factor: middle age"},{"insert":"\n"}]}
{"ops":[{"insert":"The onset of RA peaks between the ages of 40 to 50 years."}]}
{"ops":[{"insert":"Introduction"},{"insert":"\n"}]}
{"ops":[{"insert":"Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease of the joints that is of unknown etiology.\n\nGenetically susceptible individuals experience dysregulation of both innate and adaptive immunity. This results in the aberrant persistence of inflammatory cyokines and therefore, chronic inflammation. In addition, these individuals also develop autoimmunity against the synovial lining of the joints, bursae and tendon sheath.\n\nThe combined effects of both of the above mechanisms results in synovitis, synovial proliferation, and destruction of cartilage and subchondral bone."}]}
{"ops":[{"insert":"Persistent symmetric polyarthritis and joint stiffness"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients may experience joint swelling, and stiffness for a prolonged period (\u003E1 hour) upon waking. Multiple large (usually 2-10) and small joints (usually 4-10) may be involved, typically in a symmetric pattern."}]}
{"ops":[{"insert":"Constitutional symptoms"},{"insert":"\n"}]}
{"ops":[{"insert":"Fever and fatigability may occur. This is due to the systemic inflammatory response driven by inflammatory cytokines (e.g. TNF-alpha, Il-1 and IL-6)\n\nCognitive impairement and anemia may also occur. This is due to the inflammation affecting the brain, liver and bone marrow."}]}
{"ops":[{"insert":"Risk factor: smoking"},{"insert":"\n"}]}
{"ops":[{"insert":"Smoking increases the risk of developing RA by contributing to the formation of citrullinated proteins."}]}
{"ops":[{"insert":"Risk factor: female gender"},{"insert":"\n"}]}
{"ops":[{"insert":"Females are at a higher risk of developing RA. However, the use of oral contraceptive pills is protective against RA."}]}
{"ops":[{"insert":"Risk factor: genetic susceptibility"},{"insert":"\n"}]}
{"ops":[{"insert":"The presence of the heterozygotic allele HLA DRB1*0401\/*0404 confers an increased risk of developing RA."}]}
{"ops":[{"insert":"Risk factor: middle age"},{"insert":"\n"}]}
{"ops":[{"insert":"The onset of RA peaks between the ages of 40 to 50 years."}]}

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