CLINICO-PATHOLOGICAL CORRELATION IN PATIENTS OF RHEUMATOID ARTHRITIS

Introduction: Rheumatoid arthritis (RA) is an inflammatory arthritis of unknown etiology characterized by a symmetric polyarthritis with varied extra-articular manifestations. Autoantibody production with the formation of immune complexes that fix complement contribute to these extra-articular findings. Among the composite indices to measure disease activity, the DAS-28(Disease Activity Score) score system is the most commonly used parameter to measure the disease activity. Objectives: To study correlation of seropositive and seronegative patients with articular manifestations by Disease Activity Score-28. To study correlation of seropositive and seronegative patients with regards to extra-articular manifestations in Rheumatoid Arthritis. Material and Methods: This study was conducted on 72 patients of Rheumatoid arthritis as per the 2010 American College of Rheumatology (ACR) classification criteria attending our institute on Out Patient and In-Patient Department basis with age >= 18 years. Patients not giving consent were excluded from study. Results: 57 patients were seropositive (SP) and 15 patients were seronegative (SN). Sero-Positive Rheumatoid Arthritis patients manifested more active disease as they had elevated C-Reactive Protein and higher Swollen Joint Count than Sero-Negative Rheumatoid Arthritis. Extra Articular Manifestations were observed in 6 seronegative patients and 32 seropositive patients. Erythrocyte Sedimentation Rate was significantly elevated in the patients with Extra Articular Manifestations. After 6 months, change in mean Tender Joint Count, Erythrocyte Sedimentation Rate and Patient Global Assessment Score was higher in seronegative patients as compared to seropositive patients but statistically not significant. DAS-28 score was significantly reduced in seronegative patients than in the seropositive patients. Conclusion: Seropositive patients have more active disease when assessed on the basis of disease activity index at presentation. The seronegative patients showed better response to treatment indicating a low disease activity. The extraarticular manifestations develop frequently in patients with seropositivity. The DAS-28 score can be used as a guide in the suppression of disease activity with Disease Modifying AntiRheumatic Drugs.