SPECTRUM AND FREQUENCY OF EXTRA-ARTICULAR MANIFESTATIONS OF RHEUMATOID ARTHRITIS

Khomenko V.M., Ostapchuk O.I., Kuzminova N.V., Burdeyna L.V., Bykov V.A., Stanislavchuk М.А.

• Vinnytsia National Medical University named after М.І. Pirogov

Summary. Patients with rheumatoid arthritis (RA) can demonstrate the presence of clinical symptoms of affecting other organs and systems that can be decisive for the course and prognosis of the disease. The purpose of the study: according to the literature sources, to analyze the frequency and spectrum of extra-articular manifestations of RA, their relationship with demographic and constitutional indicators, markers of the activity of RA, and features of pharmacotherapy. Research results. The most common manifestation of RA on the skin is rheumatoid nodules. Patients with RA have a higher risk of coronary heart disease, heart failure, atrial fibrillation, stroke, and thromboembolic complications. The most characteristic manifestations of rheumatoid vasculitis are skin ulcers, finger gangrene, palpable purpura, and peripheral neuropathy. Pathology of the respiratory organs caused by RA is observed in every third patient, lung disease can be caused also by the toxic effect of drugs (methotrexate, leflunomide, etc.). The main ocular manifestations of RA include Sjögren’s disease, scleritis, episcleritis, iritis, uveitis, and peripheral ulcerative keratitis. Kidney damage in RA can be due to secondary amyloidosis, glomerulonephritis, a consequence of nephrotoxicity of drugs. One in five patients has RA associated with fibromyalgia. Sarcopenia and excess fat mass in patients with RA is an unfavorable factor for the deterioration of the quality of life and the development of disability. The most common mental disorder in RA is depression. The vast majority of patients have moderate normocytic hypochromic anemia, the severity of which is associated with advanced age, female sex, low iron, and high levels of C-reactive protein and ESR. Conclusions. Extra-articular manifestations of RA are often multiorgan and associated with a high titer of rheumatoid factor and antibody to cyclic citrullinated peptide. Extra-articular lesions in RA are the marker of disease severity and lead to increased overall morbidity and premature mortality.