Rheumatoid Arthritis Case Study

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INTRODUCTION Rheumatoid Arthritis is a common autoimmune disease which is associated with slow progressive disability, it can cause systemic complications, may increase morbidity and mortality and is a socioeconomic burden.[1] The exact cause of RA is still unknown.[2] However advancement in understanding the pathogenesis of disease, laid new paths for development of new therapies and treatments, with improved and better outcome. The current strategy, reflects this progress, is to initiate aggressive therapy soon after diagnosis and to carry forward that therapy as per the disease activity, in hope of pursuing a clinical remission. However several unmet needs and demands from the treatment remain there. Currently used conventional / traditional…show more content…
[3] It is responsible for production of auto-antibodies like Rheumatic Factor (RF) and anti-citrullinated protein antibodies (ACPA). It has broad extra-articular effects too in form of cardiovascular, pulmonary, psychological and skeletal disorders. The word “rheuma” was defined by Greek physician to mean “flowing” which fits well their humoral theory of disease.[4] NEED FOR STUDY RA is a common chronic disease that affects about 1% of the world population.[5] In the version 2 estimates for the Global Burden of Disease 2000 study; published in the World Health Report, 2002. Rheumatoid Arthritis is the 31st leading cause of Years Lived with Disability (YLDs) at global level accounting for 0.8% of total global YLDs. As per ICMR, the prevalence of RA varies from 0.17% to 0.64% in 2012.[6] The incidence of RA increases with increasing age in most population until about eighth decade of life, when it starts declining.[7] Around twice as many women are affected as…show more content…
However this was discontinued by the end of 2006.[17] AETIOLOGY: Although the exact cause of RA remains unknown.[2] The earliest event in RA pathogenesis is activation of the innate immune response, which includes the activation of dendritic cells by exogenous material and autologous antigens.[2,18] GENETIC FACTORS: Disease occurrence rate for monozygotic twins is about 15-30% and for dizygotic twins it is around 5% with estimated heritability of upto 60%1. The major histocompatibility complex (MHC), which is highly pleomorphic, play a vital role in gene susceptibility. More than 80% of patients suffering from RA carry the epitope of HLA-DRB1* 04 cluster2, and those who express two HLA-DRB1* 04 allels are at greater risk for developing RA in their lifes. The HLA-DRB gene variants which mapping to amino acid 70-74 of DBβ chain are strongly associated with RA[19]. Polymorphism at amino acid position 11, 71 and 74 of DRβ chain is responsible for highest chances of seropositive

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