Abstract

A REVIEW ON ETIO PATHOGENESIS AND MANAGEMENT OF RHEUMATOID ARTHRITIS IN CLINICAL PRACTICE

M.S. Umashankar*, K.S. Lakshmi, A. Bharath Kumar and A. Porselvi

ABSTRACT

Rheumatoid arthritis is a severe autoimmune disease causes the inflammation, swelling, joint pain and stiffness leads to imbalance of protective role. During the inflammation process several inflammatory cells get released causes joint inflammation. Rheumatoid arthritis can affects the hands, wrists, knees, nerves and damage the vital organs. It is strongly associated with genes of HLA-DR 4 which is the major genetic factor causes arthritis. Primarily it starts with rapid cellular activation leads to damage of protective cells and formation of immune complexes in both joints and other organs where it multiplies rapidly. The initial stage has no inflammation after the severity of disease condition release of various inflammatory cells causes joint destruction. The environmental factors, smoking, allergens, genetics, insecticides and occupational exposure contributes the arthritis development. The B-cells, T-cells, major histocompatability cells, CD4 cells having significant role in arthritis development. Treatment strategy depends on providing symptomatic relief and early diagnosis, effective implementation of therapeutic plan that impact treatment outcomes and improves the quality of life and rapidly arrest the structural joint damage. Methotrexate is the initial drug of choice in most patients with rheumatoid arthritis. The combination regimens includes methotrexate and other conventional disease modifying anti rheumatoid arthritis drugs may an effective approach to the treatment. The non pharmacological interventions includes reducing pain, inflammation, free joint movement and improvement in patient's health related quality of life. The regular monitoring of balanced rest, proper sleep, stress reduction, exercise, use of splints and braces, Pain relieving medications, corticosteroids provides many beneficial effects which will reduce the joint complications in clinical practice.

Keywords: Allergens, Genetics, HLA-DR4, Inflammation, Joint stiffness.