Rheumatoid Arthritis Overview and Pathogenesis

Rheumatoid Arthritis Overview

• Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that primarily affects joints.
• Characterized by chronic aseptic synovitis leading to erosive and destructive joint damage.
• The disease progresses over time, potentially causing destruction of articular cartilage and bone.
• RA can also result in damage to visceral organs, highlighting its systemic nature.

Pathogenesis

• Two major subtypes of RA are distinguished by the presence or absence of anti-citrullinated protein antibodies (ACPAs).
• Citrullination, a key process in RA, is facilitated by the enzyme peptidylarginine-deiminase (PAD), which is calcium-dependent.

Disease Course

• Initially may present as oligo-arthritis (involving a few joints) but typically progresses to polyarthritis (involving multiple joints).

Diagnosis Criteria

• ACR & EULAR 2010 classification criteria necessitate a total of 6 points for a diagnosis of RA.

Antibodies and Disease Detection

• The presence of rheumatoid factor (RF) varies in RA and other diseases; specifically seen in:
  • RA: 60-80%
  • Juvenile arthritis: 15%
• ACPA (anti-CCP antibodies) show high specificity (>90%) and moderate sensitivity (56-80%) for RA.
• Approximately 50-60% of anti-CCP antibodies can be detected within 3-6 months after the onset of RA symptoms.
• The prevalence of anti-CCP antibodies in healthy individuals is notably low.

Rheumatoid Arthritis Overview

• Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that primarily affects joints.
• Characterized by chronic aseptic synovitis leading to erosive and destructive joint damage.
• The disease progresses over time, potentially causing destruction of articular cartilage and bone.
• RA can also result in damage to visceral organs, highlighting its systemic nature.

Pathogenesis

• Two major subtypes of RA are distinguished by the presence or absence of anti-citrullinated protein antibodies (ACPAs).
• Citrullination, a key process in RA, is facilitated by the enzyme peptidylarginine-deiminase (PAD), which is calcium-dependent.

Disease Course

• Initially may present as oligo-arthritis (involving a few joints) but typically progresses to polyarthritis (involving multiple joints).

Diagnosis Criteria

• ACR & EULAR 2010 classification criteria necessitate a total of 6 points for a diagnosis of RA.

Antibodies and Disease Detection

• The presence of rheumatoid factor (RF) varies in RA and other diseases; specifically seen in:
  • RA: 60-80%
  • Juvenile arthritis: 15%
• ACPA (anti-CCP antibodies) show high specificity (>90%) and moderate sensitivity (56-80%) for RA.
• Approximately 50-60% of anti-CCP antibodies can be detected within 3-6 months after the onset of RA symptoms.
• The prevalence of anti-CCP antibodies in healthy individuals is notably low.

This quiz provides a comprehensive overview of rheumatoid arthritis (RA), including its pathogenesis, disease course, and diagnostic criteria. You'll learn about the autoimmune nature of RA, its implications for joint and organ health, and the significance of specific antibodies in diagnosis. Test your knowledge and understanding of this complex condition.