INFO - Hematologic manifestations of RA

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Postgraduate Medicine

November 2003

" Rheumatoid arthritis: Targeted interventions can minimize joint

destruction "

Excerpt:

" Hematologic manifestations

The majority of patients with rheumatoid arthritis have a

normochromic-normocytic anemia of chronic disease. However, some patients

may also be deficient in iron, folic acid, or vitamin B12. Felty's syndrome

occurs most commonly in patients in whom seropositive nodules develop. It is

characterized by the triad of chronic and often quiescent rheumatoid

arthritis, neutropenia, and splenomegaly, sometimes with lymphadenopathy,

thrombocytopenia, and leg ulcers. Large granular lymphocytes can be seen in

the peripheral blood and bone marrow in a subset of patients with rheumatoid

arthritis.

Active rheumatoid disease is generally associated with an elevated

erythrocyte sedimentation rate (a nonspecific indicator of inflammation).

However, a number of investigators believe that C-reactive protein is a

better measure of disease activity than the routine erythrocyte

sedimentation rate. Other laboratory abnormalities include thrombocytosis (a

reflection of acute and chronic inflammation), polyclonal or monoclonal

hypergammaglobulinemia, and a positive antinuclear antibody assay. In

patients with Sjögren's syndrome, results positive for anti-SS-A or

anti-SS-B antibodies may also be found. Patients with rheumatoid arthritis

and concomitant autoimmune thyroiditis have antithyroglobulin or

antithyroperoxidase antibodies.

The risk of lymphoma in patients with rheumatoid arthritis is independent of

immunosuppressive therapy and is two to three times that of the general

population. There is no association between rheumatoid arthritis and

nonlymphoid malignancies (8). "

http://www.postgradmed.com/issues/2003/11_03/williams.htm

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