Summary
Rheumatoid arthritis (RA) is an autoimmune, systemic, inflammatory condition causing pain and inflammation primarily in the joints of the hands and feet (Macedo et al;2016) .
Comorbidities in RA are defined as one or more additional disorders (or diseases) associated with primary disease. (Michaud et al ;2007).
The presence of comorbidities may increase the mortality of RA patients and affect their treatment strategies, resulting in worse outcomes ( Norton , et al; 2013).
According to this, the prediction and management of comorbidities have been increasingly important in the long-term management of RA (Agca,et al;2017)
The aim of work is to Study prevalence of comorbidities in patients with rheumatoid arthritis.
200 rheumatoid arthritis (RA) patients diagnosed according to the American College of Rheumatology/European League Against Rheumatism ( ACR/EULAR) 2010 classification criteria were included in our study .All patients were subjected to full history taking ,clinical examination ,assessment of disease activity using DAS-28 score. All patients were subjected to 2016 American College of Rheumatology patient history form also assessment of DM by Fasting and post prandial blood glucose level and Standardized questionnaire for diabetes
All data were tabulated and summarized in termes of mean± standard deviation (SD) and range for quantitative data and frequency and percentage for quantitative data .
Their disease duration ranged from 1 to 40 years and their DAS ranged from 2.64 to 4.7 with (mean ±SD 3.67±1.03). Their ESR ranged from 29 to 67 (mean±SD 48±19) 42% of patients were receiving corticosteroids, with a dose ranging from 5 to 20 mg/day.
In our study there was statistically significant positive correlation between cases group and control group regarding CVD including hypertension. while there was no statistically significant correlation regarding other values (DVT-IHD-RHD)between both groups.
Also there was high statistically significant positive correlation between cases group and control group regarding respiratory comorbidities , IPF and pleurisy .also chest infection was statistically significant different in cases group from control group with p value < 0.011 There was no statistically significant correlation regarding other values between both groups.
Our study shows that there was high statistically significant positive correlation between cases group and control group regarding Gastrointestinal comorbidities specially gastritis . There was no statistically significant correlation regarding other values between both groups
In our study there was statistically significant positive correlation between cases group and control group regarding renal comorbidities specially including pyuria and CKD. There was no statistically significant correlation regarding hematuria between both groups .
It also shows that there was high statistically significant positive correlation between cases group and control group regarding neuropsychiatric comorbidities including depression . There was no statistically significant correlation regarding other values between both groups
Also shows that there was high statistically significant positive correlation between cases group and control group regarding FMS .while there was no significant correlation regarding DM
Frequency of anemia among cases group was 114 cases 57% while about 16 cases 8% of control group were anemic with high significant difference( p value < 0.001)
In our study there was high statistically significant positive correlation between cases group and control group regarding cardiovacular comorbidities including hypertension in relation to disease duration . There was no statistically significant correlation regarding other values between both groups
It also shows statistically significant positive correlation regarding respiratory comorbidities including (IPF-chest infection-pleurisy) in relation to disease duration .while asthma show no significant correlation with disease duration. Regarding gastrointestinal comorbidities including (gastritis-liver cirrhosis-HCV) there was statistically significant correlation with disease duration .
In our statistics there was significant positive correlation between cases group and control group regarding renal comorbidities including pyuria and CKD and disease duration .
There was statistically significant correlation regarding neuropathy and depression between both groups regarding disease duration .
In this study there was no significant correlation regarding CVD, respiratory, GIT, neuropsychiatric comorbidities except for CKD in relation to DAS score .
Among rheumatoid arthritis patients, rheumatoid nodules were detected in 36 cases about 164 cases didn’t have rheumatoid nodules , (38.9%) of cases associated with rheumatoid nodules were suffering from cardiovascular comorbidities which was statistically significant different (p value , 0.012) than patients with no rheumatoid nodules , (36.1 %) of cases associated with rheumatoid nodules were suffering from hypertension comorbidities which was statistically significant different (p value , 0.005) than patients with no rheumatoid nodules (15.9%) .
Regarding pulmonary comorbidities(44.4%) of cases associated with rheumatoid nodules were suffering from respiratory comorbidities which was high statistically significant different (p value , 0.001) than patients with no rheumatoid nodules(14.6%) , 6 cases among patients associated with rheumatoid nodules were suffering from IPF which was high statistically significant different (p value , 0.001) than patients with no rheumatoid nodules (4 cases only) . frequency of bronchial asthma and pleurisy were statistically significant different (p value ,0.007 ),p value 0.018) consecutively than patients with no rheumatoid nodules .
About 80.6% of cases associated with rheumatoid nodules were suffering from GIT comorbidities which was high statistically significant different (p value |
