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Pharmacology I

APHE Anatomy, Physiology, and Health Education

Pharmaceutical Analysis

Pharmacy study material

Bones and Skeleton System

Bone disease (Gout) (Rheumatoid arthritis) (Osteoarthritis) (Osteoporosis)

Cancer and music therapy

Memory of water

Rheumatoid arthritis: Cause, Diagnosis and Treatment

Rheumatoid arthritis

Chronic progressive inflammatory disorder characterized by joint pain, swelling, redness and disability.

Etiology of Rheumatoid arthritis

(i.) human leukocyte antigen (HLA)-DRB1 locus (in patients positive for rheumatoid factor) activates the autoantibody production (rheumatoid factor and anti-citrullinated protein antibody [ACPA]) via T cell activation pathway

(ii.) Infectious agents (eg Epstein-Barr virus, Cytomegalovirus, Proteus species, and Escherichia coli) and their products (e.g., heat-shock proteins)

(iii.) Nuclear factor $\kappa$B (NF-$\kappa$B)-dependent signalling pathway.

Diagnosis:

Physical:

Morning stiffness, fatigue, weakness, low-grade fever, loss of appetite, and joint pain, myalgias may precede development of synovitis.

Affected joints

Polyarticular: Intercarpal and carpal-metacarpal-phalanges joints are firstly affected followed by the joints of wrists, ankles, elbw, tarsal-metatarsal-phalanges, shoulder girdle and pelvic girdle.

Laboratory:

Elevated erythrocyte sedimentation rate and C-reactive protein, positive rheumatoid factor (60% to 70% of patients); positive anticyclic citrullinated peptide antibody (50% to 85% of patients).

Radiological:

Soft tissue swelling and osteoporosis near the joint (periarticular osteoporosis) in the early stage of the disease, joint erosions later in the disease, pennus formation, decalcification of localized area.

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