Rheumatoid arthritis (RA) occurs world wide in all ethnic groups and peak incidence is in the fifth decade.
CRITERIA
The following are the revised criteria of American Rheumatology Association (ARA), for diagnosing RA:
"MORNING Always Helps to See Nature Fresh and RADIANT"
The presence of atleast 4 criteria is required for the diagnosis of RA. The diagnosis is based on a collection of clinical features
Poor prognostic factors are female sex, extra-articular disease, high concentration of RA Factor & HLA-DR4
Rheumatoid factor is positive in upto 80% of patients. Both the ESR and CRP are elevated in active disease and correlate with disease severity
The causes of anaemia in RA are many:
a) Normochromic normocytic anaemia due to chronic disease
b) Hypochromic microcytic anaemia due to NSAID's causing chronic blood loss and iron deficiency
c) Macrocytic anaemia resulting from folate deficiency from Sulphasalazine or Methotrexate and d) B12 deficiency associated with Pernicious anaemia
e) Haemolytic anaemia (drug induced) f) Bone marrow suppression from drugs g) Hypersplenism as in Felty's syndrome
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