| Rheumatoid arthritis (RA) is a disease that affects | | | | IgG, and IgA classes. The rheumatoid factor or RF is |
| millions of individuals around the world every year. | | | | present in eighty-five to ninety percent of individuals |
| Many RA sufferers express pain, not only in the | | | | with rheumatoid arthritis. |
| smaller joints of the hands and feet, but neck pain, | | | | RA may be stimulated by a self-antigen; or an antigen |
| back pain, and even sciatica in severe manifestations. | | | | in the synovial cavity, the space between the joints |
| Approximately one per cent of the world's population, | | | | where fluid to lubricate the joints is present and |
| one in ten thousand individuals, are affected by | | | | necessary for movement; or an infective antigen, |
| rheumatoid arthritis. There appears to be a significant, | | | | foreign agent or body causing an adverse reaction. |
| gender-based difference, with three to five times as | | | | The rheumatoid arthritis continues to interact with IgG |
| many women as men presenting with symptoms. | | | | even in the absence of any specific antigen or invading |
| Interestingly, smokers appear to be at significantly | | | | foreign body. Chronic antigen stimulation, such as |
| greater risk than non-smokers, up to four times as | | | | occurs in chronic respiratory infections, causes the |
| many smokers as non-smokers exhibit the disorder, | | | | production and destruction of large amounts of |
| although the reasons for this disparity are not clear. | | | | antibody needed to fight infection. The RF-IgG |
| Rheumatoid arthritis is characterized by morning | | | | complexes are present in the rheumatoid lesions and |
| stiffness, arthritis at three or more joint areas, arthritis | | | | apparently activate complement or prostaglandins or |
| of the hand joints, symmetrical arthritis, rheumatoid | | | | other substances that promote the inflammatory |
| nodules, serum RF, and radiographic changes. | | | | response. The inflammatory response may vary in |
| Rheumatoid arthritis principally affects the joints, both | | | | degree and location depending on the myriad of |
| large and small, but may impact other organs as well. | | | | factors, to include age at onset and location of the |
| Extra-articular expressions of RA, evident in as high as | | | | specific inflammatory response. In older RA sufferers, |
| twenty-five percent of all individuals with the disorder, | | | | the pain is frequently felt in the neck and deep in the |
| may impact the skin, lungs, kidneys, heart, blood and | | | | low back, among other areas, even resulting in sciatica |
| blood vessels, eyes, liver, and even the nerves. | | | | in severe incidents of low back pain spreading into the |
| Rheumatoid arthritis may also lead to chronic fatigue, | | | | buttocks and legs. |
| loss of appetite and weight, malaise, listlessness and, in | | | | The arthritis associated with RA is due to an |
| some cases, a low-grade fever. Osteoporosis and | | | | inflammation in the synovial capsule, specifically of the |
| lymphoma have also been diagnosed in patients with | | | | synovial membrane. Synovial fluid is crucial for joint |
| rheumatoid arthritis, although a causal link is still unclear. | | | | movement and, when synovitis is present, the joints |
| Given the constellation of symptoms, it is not surprising | | | | become stiff, swollen, and extremely painful. We will |
| that pain is expressed as being widespread, ranging | | | | discuss rheumatoid arthritis's impact on the body, and |
| from mild to acute, and fleeting to often chronic, | | | | its many extra-articular expressions, to include areas |
| particularly in advanced stages. | | | | most affected by deformity, loss of function, and pain. |
| Rheumatoid arthritis (RA) is a chronic, systemic, | | | | Treatment strategies for rheumatoid arthritis include a |
| inflammatory disease that specifically affects the | | | | multitude of factors, clearly a holistic approach is |
| smaller joints of the hands and feet in the earlier | | | | required. Pain, first localized in the smaller joints, |
| stages and involves the larger joints in the later stages. | | | | particularly those of the hand, spreads and grows in |
| RA ultimately results in chronic pain over widespread | | | | intensity as the disease progresses until finally pain is |
| areas of the body, to include neck pain, back pain, and | | | | chronic and widespread. The fact that RA impacts the |
| sciatica. It is nonsuppurative but finally results in the | | | | joints exacerbates degeneration and consequently |
| destruction of cartilage and joints. It also may produce | | | | leads to often acute and chronic neck pain, back pain, |
| lesions of the heart valves, pericardium, myocardium, | | | | and sciatica in the latter stages of the disorder. |
| and pleura. The pathophysiologic manifestations | | | | Specific strategies for dealing with this disorder, |
| appear to result from the development antibody | | | | beyond those medications prescribed, will be discussed |
| against IgG. IgG makes up about 80% of the antibodies | | | | in the next article on this topic. Until then, know that |
| in plasma. Plasma is the fluid portion of blood. IgG is a | | | | relief is possible and long lasting, provided certain |
| crucial actor in the body's ability to respond to and fight | | | | strategies are implemented and adhered to. Again, we |
| and sort of antigen, foreign matter in the body. These | | | | will discuss those in part two, tomorrow. |
| antibodies, called rheumatoid factor, belong to the IgM, | | | | |