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It is generally considered that a genetic predisposition (HLA-DR B1 which is the most common allele of HLA-DR4 involved in RA) and an environmental trigger (Epstein-Barr virus postulated as a possible antigen, but not proven) lead to an autoimmune response that is directed against synovial structures and other organs.
Activation and accumulation of T CD4 cells in the synovium starts a cascade of inflammatory responses which result in: The inflammatory response leads to pannus formation.
Pulmonary disease may involve the airway, interstitum, and/or pleura; a full description is available in respiratory manifestations of rheumatoid arthritis.
Splenomegaly may be seen as part of Felty syndrome, usually in longstanding RA.
If you've been diagnosed with rheumatoid arthritis, your doctor may recommend that you begin treatment with one of several types of DMARDs within a few months of diagnosis.
One of the most important drugs in the arsenal for treating rheumatoid arthritis, DMARDs can often slow or stop the progression of RA by interrupting the immune process that promotes inflammation.
Pannus is an oedematous thickened hyperplastic synovium infiltrated by lymphocytes T and B, plasmocytes, macrophages and osteoclasts.
Pannus will gradually erode bare areas initially, followed by the articular cartilage.
• Abdominal pain • Chills or fever • Dizziness • Hair loss • Headache • Light sensitivity • Itching • Liver problems • Low blood counts Rare, but serious: Dry cough, fever, or trouble breathing, which may result from lung inflammation Biologic response modifiers are a type of DMARD.
They target the part of the immune system response that leads to inflammation and joint damage.