OUR article on arthritides- joint diseases- apparently stirred the hornet’s nest, so to speak. We have been at the receiving end of calls and text from our readers, most of them women, wanting more information about their supposed ‘female type of arthritis”, their voices quivering with anxiety expressing fear that how come, treatment of rheumatoid arthritis is more complex than the usual osteoarthritis-rayuma--the most common degenerative –aging –related – join disease.
For a starter, the autoimmune nature of rheumatoid arthritis. Dear readers, please allow your columnist to walk down with you into basics of immunology.
Whenever a substance is introduced into our body- ingested or injected or inhaled- examples are food, medicines, pollens, our immune system right away identifies these substances as an “antigen,” in short a foreign substance, or a non-self; and the immediate reaction is to produce “antibodies,” to use a layman’s term, as soldiers to fight the invader, to neutralize it or better yet, destroy it completely. In the so-called autoimmune disease, for some reasons not yet fully understood even by experts and scientists, a peculiar kind of antibodies called “auto antibodies” are formed, which sadly, instead of fighting the invading non-self-foreign substance, directs its attack on the tissues and cells of the person himself/herself. As said earlier, it is the synovium- fibrous membrane that lines the inner surfaces of the joints that are affected, leading to rheumatoid arthritis.
Your columnist is happy to share with you the salient points of distinguished rheumatologist Dr Kelly O’Neill Young, who emphasized that “strictly speaking, RA is not just a type of arthritis. Rather, arthritis is only one symptom of what many investigators, researchers and clinicians have called ‘rheumatoid disease’”. While it is true that most patients with RA have the signs and symptoms- inflammation, pain, deformity, and limitation of motion- concentrated on the joints, arthritis is not necessarily the first nor most life-impacting symptom.
Despite what is commonly taught in health sciences schools and what patients are usually told, there are extra-articular manifestations of the disease, which must be paid attention to, because of their potentially serious complications.
Current data in the field of rheumatology and rehabilitation medicine list the following as extra-articular – outside of joint involvement- tissue or organs which are part and parcel of the broader illness called rheumatoid disease; mouth, larynx or voice box, cardiovascular system, vasculitis/blood vessels, eyes, lungs, kidneys, spleen, liver lymph nodes, skin, on top of that, constitutional symptoms like fever, fatigue, muscle wasting or cachexia as well as infections.
Take home message, rheumatoid arthritis is not something we can just casually brush aside with the usual, “tumatanda ka na.” If you or a loved one has suspected signs and symptoms of rheumatoid arthritis, find a doctor who will start observation, monitoring and treatment as soon as possible to attempt to prevent onset of a more serious full-blown disease.