Adla B Hassan
Arabian Gulf University, Bahrain
Title: Organ-specific rheumatoid arthritis is it a separate disease entity?
Biography
Biography: Adla B Hassan
Abstract
Statement of the Problem: Rheumatoid arthritis is a systemic autoimmue disease. However, organ-specific rheumatoid arthritis (monoarthritis) has rarely been reported. It is not uncommon to see a rheumatoid arthritis patient who has only one single joint involvement (monoarthritis). Hence, there are no guidelines to demonstrate how to treat such patients. The purpose of this study is to describe the experience of encountering a rheumatoid arthritis patient with monoarthritis. Methodology & Theoretical Orientation: A 34 years old Bahraini female referred to my clinic on 2nd September 2014 from an orthopedic clinic, complaining of pain and swelling of her right knee, her symptoms started 6 months previously with only pain in her right knee and overtime she it developed swelling. No history of trauma, rest of history is insignificant except for mild fatigability and maylgia. Physical examination is significant only for the right knee which was swollen on the medial aspect, mildly tender, but not red or hot, quite the opposite; it was colder than the left knee. Findings: Extensive laboratory evaluation revealed positive rheumatoid factor, high anti-CCP (763.6 U/ml), high ESR (30), high CRP (17), high ANA (1:320), ENAs was negative, Plain X-ray was normal, patient refused to do MRI. Accordingly, the patient was diagnosed as seropositive rheumatoid arthritis (? organ-specific) and started on MTX (12.5mg Once/week), folic acid (5mg once/week) and plaquinil (400mg OD). After 9 months on therapy and up-to-date the patient was improved on all aspects, she became completely asymptomatic and all labrotary parameters went down, but still not normal. Conclusion & Significance: Early detection and treatment of the rheumatoid arthritis patient presents with monoarthritis could promise early remission.