Rheumatoid arthritis natural history: Difference between revisions
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==Prognosis== | ==Prognosis== | ||
The course of the disease varies greatly from patient to patient. Some patients have mild short-term symptoms, but in most the disease is progressive for life. Around 20%-30% will have subcutaneous nodules (known as rheumatoid nodules); this is associated with a poor prognosis. | |||
===Disability=== | |||
*Daily living activities are impaired in most patients. | |||
*After 5 years of disease, approximately 33% of patients will not be working | |||
*After 10 years, approximately half will have substantial functional disability. | |||
===Prognostic factors=== | |||
*Poor prognostic factors include persistent synovitis, early erosive disease, extra-articular findings (including subcutaneous rheumatoid nodules), positive serum RF findings, positive serum anti-CCP autoantibodies, carriership of HLA-DR4 "Shared Epitope" alleles, family history of RA, poor functional status, socioeconomic factors, elevated acute phase response (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and increased clinical severity. | |||
==References== | ==References== | ||
Revision as of 18:05, 23 August 2012
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Risk calculators and risk factors for Rheumatoid arthritis natural history | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Natural History
Complications
Rheumatological
- Joint deformitites
- Felty's syndrome
- Sjögren's syndrome
Cardiac complications
Pulmonary complications
Eye complications
- Scleritis, and
- Subcutaneous nodules
Renal complications
Nervous system complications
Orthopedic complications
- Erosion of the odontoid process and or/transverse ligaments in the cervical spine
- Osteoporosis
- Atlanto-axial subluxation
Hematological complications
Prognosis
The course of the disease varies greatly from patient to patient. Some patients have mild short-term symptoms, but in most the disease is progressive for life. Around 20%-30% will have subcutaneous nodules (known as rheumatoid nodules); this is associated with a poor prognosis.
Disability
- Daily living activities are impaired in most patients.
- After 5 years of disease, approximately 33% of patients will not be working
- After 10 years, approximately half will have substantial functional disability.
Prognostic factors
- Poor prognostic factors include persistent synovitis, early erosive disease, extra-articular findings (including subcutaneous rheumatoid nodules), positive serum RF findings, positive serum anti-CCP autoantibodies, carriership of HLA-DR4 "Shared Epitope" alleles, family history of RA, poor functional status, socioeconomic factors, elevated acute phase response (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and increased clinical severity.