Clinico-Immunologic Peculiarities of Different Forms of Rheumatoid Arthritis.
The problem of searching different immunologic, clinical and laboratory signs and parameters characterizing evaluation of the rheumatoid arthritis (RA) and the early prognosis of its outcome cause interest to studying peculiarities of immunologic status and changes of some serologic markers in different RA forms. The comparison of clinico-immunologic data in seropositive and seronegative patients revealed the most pronounced changes in patients with extraarticular manifestations (EAM), positive to IgM-RF. In this case the direct correlation with RA severity was seen in the both RA forms. The comparison analysis of the data obtained revealed the most pronounced changes in seropositive patients with EAM. This allowed us to consider this RA variant as the most unfavorable. EAM RA together with progression of articular process provided the RA severity and could cause patients' lethality. In seronegative RA form the level of ESR, CIC, Abs to nucleic acids enabled to stipulate the articular form (AF) as the most unfavorable that was accompanied with the most rapid progression of destruction events. One of the heights levels of anticardiolipin antibodies (aCL) and factor VIII-related von Willebrand polymers (factor VIII:vWF) were associated with EAM. Additionally, the indices' shifts were increased in seronegative RA that corresponded to vascular disturbances. The RA activity correlated with quantitative and/or qualitative parameters of CD3, CD4, CD8 lymphocytes, IgM-RF and immunoglobulins. Thus, the present study revealed two forms of RA associated with rapid development of articular destruction and extraarticular complications: seropositive EAM and seronegative AF forms. Additionally, the association of elevated aCL, and factor VIII:vWF with development of different EAM in RA in the both RA forms was found out.
Artemenko
Natalya A.
NA
Rostov State Medical University, Rostov-on-Don, Russia.
Sizyakina
Ludmila P.
LP