Rheumatoid Arthritis
Rheumatoid Arthritis
Rheumatoid Arthritis
ARTHRITIS
DEFINITION
Rheumatoid
arthritis,achronic,
systemic,
inflammatory
autoimmune
disease,hasasits
primarytargetthe
synovialtissues.
ETIOLOGY
Thedefinitcauseofrheumatoidarthritisis
unknown,becauseitisverycomplicatedandthe
scientistisstilldoingthesurveilance,butthe
mechanisminpathologycanconcludeseveralcauses
ofRA
immune
regulatoryfactors
Gene
Smoking
andotherformsof
environment
bronchialstress
Sexhormone Androgen
Infection Abnormal
imunerespon
EPIDEMIOLOGY
InIndonesia,the
prevalenceisunder0,4%.
Incentraljavathe
Thehigh prevalenceisabout0.2%,
prevalencefound inMalang0,5%.
inPimaIndian InRSCipto
MangunkusumoJakarta,
andChippewa
insidensofRAfrom
Indian,about januaryuntilJune2007is
5,3%and6,8% about203case.
Thecaseis
usuallyfoundin
woman
PATHOLOGY
Jointdamageoccurswhenthelimfosit,macrofagandfibroblas
areoccurinthesynovialtissues
Inflammationandoclusiofartery
Irregulartissue
Breakdownthecartilago
progressivedisabilityinmovement
Thediseaseoftenbegins
slowly,usuallywithonly
minorjointpain,stiffness,
andfatigue.
RAusuallyaffectswrists,
fingers,knees,feet,and
ankles.
SYMTOPMATHOLOGY
Mainsymptoms:
Morningstiffness,whichlastsmorethan1hour,iscommon.
Jointsmayfeelwarm,tender,andstiffwhennotusedforanhour.
Jointpainisoftenfeltonthesamejointonbothsidesofthebody.
Overtime,jointsmaylosetheirrangeofmotionandmaybecome
deformed.
Othersymptoms:
Chestpainwhentakingabreath(pleurisy)
Dryeyesandmouth(Sjogrensyndrome)
Eyeburning,itching
Noduleundertheskin(usuallyasignofmoreseveredisease)
Numbness,tingling,orburninginthehandsandfeet
Sleepdifficulties
DIAGNOSIS
Sevendiagnosticcriteria:
1. morningstiffness,
2. arthritisofthreeormorejointareas,
3. arthritisofthehandjoints
4. symmetricarthritis,
5. rheumatoidnodules,
6. elevatedlevelsofserumrheumatoidfactor,
7. Radiographicchanges.
thefirstfourcriteriamustbepresent
foraminimumofsixweeksbeforeadiagnosisofrheumatoidarthritis
canbemade
WecanuseCreactiveprotein(CRP),EritrositSedimentRate(ESR),Joint
xraytohelpusmakediagnosis
THERAPHY/TREATMENT
Nonsteroidalantiinflammatorydrugs(NSAIDs)
Corticosteroids(glucocorticoid)
Diseasemodifyingantirheumaticdrugs(DMARD):methotrexate