Re: Miscarriage Associated With Progressive Joint Disease in RA

[Guest guest]

I had at least three known miscarriages and have always felt there was something

underlying causing it.

Becky

[ ] Miscarriage Associated With Progressive Joint Disease in

RA

Miscarriage Associated With Progressive Joint Disease in Rheumatoid

Arthritis

By Will Boggs, MD

NEW YORK (Reuters Health) Jul 20 - A history of miscarriage before the onset

of rheumatoid arthritis (RA) is associated with progressive joint disease in

women with the disease, according to a report in the August ls of the

Rheumatic Diseases.

" Once a patient presents with RA it would be helpful to predict the amount

of joint destruction over time and to establish whether that patient will

need more aggressive treatment, " Dr. Frederique M. van Dunne from Leiden

University Medical Center, The Netherlands told Reuters Health. " Past

reproductive history could be one of the factors which will assist in

distinguishing the more severe RA from the less severe at first visit. "

Dr. van Dunne and colleagues investigated whether a less favorable

reproductive outcome was associated with more severe rheumatoid arthritis by

studying the reproductive history and rate of joint destruction of 113 women

with newly diagnosed rheumatoid arthritis.

The time to pregnancy (fecundity) showed no association with the progression

of joint damage over the 24-month study. In contrast, the authors report, a

history of at least one miscarriage was associated with a significant

increase in joint destruction, even after adjustment for other prognostic

factors.

Despite slight differences in baseline disease activity score and C-reactive

protein concentrations between women with and without miscarriages, the

researchers note, both outcomes were similar at the end of two years.

" Our results could indicate that the phenotype of joint destruction is

associated with the phenotype of reported miscarriages, suggesting that

there are common genetic risk factors for each of these two traits, possibly

acting through the innate Th1/Th2 phenotype, " the investigators conclude.

" Further studies are being done on progressive joint destruction, " Dr. van

Dunne said. " Extensive research is being done on pregnancy and the Th1/Th2

balance, and we are in the process of writing up a study on Th1/Th2

cytokines and pregnancy in the general population. "

Ann Rheum Dis 2004;63:956-960.