Relationship between Different Hematological Parameters and Disease Activity in Patients with Rheumatoid Arthritis
DOI:
https://doi.org/10.56056/amj.2024.236Keywords:
Chronic cases, Disease activity score, Hematological parameters, Rheumatoid arthritisAbstract
Background and objectives: Rheumatoid arthritis is a type of immune disorder that has an impact on the entire body. The objective was to measure and compare various hematological parameter values between chronic and new cases also in new patients who exhibited varying degrees of disease activity.
Methods: This study was a cross-sectional survey, conducted in Rizgary Hospital and private clinics in Erbil city/ Kurdistan Region of Iraq. Two groups each of 30 patients; with newly diagnosed the 2010 ACR/EULAR criteria are divided into four groups, each of which has a point score: joint symptoms, serology (including Rheumatoid factor and/or Anti-Citrullinated Peptide Antibody), duration of symptoms (less than or more than 6 weeks), and acute-phase reactants (c-reactive protein and/or erythrocyte sedimentation rate) and chronic Rheumatoid Arthritis cases enrolled in this study from October 2021 till September 2022. Hematological parameter and disease activity monitored and compared between both groups, in addition to comparison between cases in the same group.
Results: The majority (81.7%) of patients were female and (18.3%) of them were male, mean age ± std. deviation of respondents was 48.80 ± 9.13 years. There was significant statistical association between study groups and joint swelling, multiple or single joint and disease activity (DAS 28), also, the difference between both groups was statistically significant regarding mean pain score, white blood cells, serum folate, and rheumatoid factor. Likewise; the association was significant between study groups and multiple or single joint. There was significant statistical association between study groups and DAS 28, the majority (86.7%) of newly diagnosed patients had low – moderate level of DAS 28 while 40% of chronic subjects measured high level of DAS 28.
Conclusion: Hematological markers including disease activity score, white blood cells, serum folate, C-reactive protein and rheumatoid factor were good indicators for measurement of rheumatoid arthritis severity and activity in the selected sample of patients.
Downloads
References
Aletaha D, Smolen JS. Diagnosis and Management of Rheumatoid Arthritis: A Review. JAMA. 2018; 320(13):1360-72. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30285183.
Guo Q, Wang Y, Xu D, Nossent J, Pavlos NJ, Xu J. Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies. Bone Res. 2018; 6:15. Available from:https://www.ncbi.nlm.nih.gov/pubmed/29736302.
Figus FA, Piga M, Azzolin I, McConnell R, Iagnocco A. Rheumatoid arthritis: Extra-articular manifestations and comorbidities. Autoimmun Rev. 2021; 20(4):102776. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33609792.
Ruaro B, Casabella A, Paolino S, et al. Dickkopf-1 (Dkk-1) serum levels in systemic sclerosis and rheumatoid arthritis patients: correlation with the Trabecular Bone Score (TBS). Clin Rheumatol 2018; 37(11):3057-62.
Available from: https://doi.org/10.1007/s10067-018-4322-9.
Coenen MJ, Gregersen PK. Rheumatoid arthritis: a view of the current genetic landscape. Genes Immun. 2009; 10(2):101-11. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18987647.
Smolen JS, Breedveld FC, Schiff MH, et al. A simplified disease activity index for rheumatoid arthritis for use in clinical practice. Rheumatology. 2003; 42(2):244-57.
Available from: https://doi.org/10.1093/rheumatology/keg072.
Van der Heijde DM, Van’t Hof M, van Riel PL, van de Putte LB. Development of a disease activity score based on judgment in clinical practice by rheumatologists. J Rheumatol. 1993; 20(3):579-81. Available from: https://www.ncbi.nlm.nih.gov/pubmed/8478878.
Aletaha D, Smolen J. The Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI): a review of their usefulness and validity in rheumatoid arthritis. Clin Exp Rheumatol. 2005; 23(5 Suppl 39): S100-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16273793.
Smolen JS, Landewé R, Breedveld FC, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis. 2010; 69(6):964.
Available from: http://ard.bmj.com/content/69/6/964.abstract.
Ganz T. Anemia of Inflammation. Engl J Med. 2019; 381(12):1148-57. Available from: https://www.nejm.org/doi/full/10.1056/NEJMra1804281.
Kounis NG, Soufras GD, Tsigkas G, Hahalis G. White Blood Cell Counts, Leukocyte Ratios, and Eosinophils as Inflammatory Markers in Patients with Coronary Artery Disease. Clin Appl Thromb Hemost. 2014; 21(2):139-43. Available from: https://doi.org/10.1177/1076029614531449.
Stokes KY, Granger DN. Platelets: a critical link between inflammation and microvascular dysfunction. J Physiol. 2012; 590(5):1023-34.
Available from: https://physoc.onlinelibrary.wiley.com/doi/abs/10.1113/jphysiol.2011.225417.
Talukdar M, Barui G, Adhikari A, Karmakar R, Ghosh UC, Das TK. A study on association between common haematological parameters and disease activity in rheumatoid arthritis. J Clin Diagn Res. 2017; 11(1):EC01.
Available from: https://pubmed.ncbi.nlm.nih.gov/28273969/.
I??k M, ?ahin H, Hüseyin E. New platelet indices as inflammatory parameters for patients with rheumatoid arthritis. Eur J Rheumatol. 2014; 1(4):144.
Available from: https://pubmed.ncbi.nlm.nih.gov/27708900/.
Tekeoglu I, Gurol G, Harman H, Karakece E, Ciftci IH. Overlooked hematological markers of disease activity in rheumatoid arthritis. Int J Rheum Dis. 2016; 19(11):1078-82.
Available from: https://www.ncbi.nlm.nih.gov/pubmed/26620362.
Chandrashekara S, Rajendran A, Bai Jaganath A, Krishnamurthy R. Neutrophil-lymphocyte ratio, pain perception, and disease activity score may serve as important predictive markers for sustained remission in rheumatoid arthritis. Reumatismo. 2015; 67(3):109-15.
Available from: https://www.ncbi.nlm.nih.gov/pubmed/26876190.
Dechanuwong P, Phuan-Udom R. Hematological parameters as a predictor of disease remission in patients with rheumatoid arthritis. Ann Med Surg (Lond). 2021; 72:103085.
Available from: https://www.ncbi.nlm.nih.gov/pubmed/34868575.
Tekeo?lu I, Gürol G, Karakeçe E, Harman H, Çiftçi IH. AB0247 Mean Platelet Volume: A Controversial Marker of Disease Activity in Rheumatoid Arthritis. Ann Rheum Dis. 2014; 73(2):885.
Available from: https://ard.bmj.com/content/annrheumdis/73/Suppl_2/885.2.full.pdf.
Wolfe F, Michaud K. Anemia and renal function in patients with rheumatoid arthritis. J Rheumatol. 2006; 33(8):1516-22.
Available from: https://www.ncbi.nlm.nih.gov/pubmed/16881108.
Ganna S. The prevalence of anemia in rheumatoid arthritis. Rev Bras Reumatol. 2014; 54(4):257-9.
Available from: https://www.ncbi.nlm.nih.gov/pubmed/25627219.
Mirza RR. Types of anaemia and its correlation with disease activity in patients with rheumatoid arthritis among kurdish population of Iraq. Iraqi J. Hematology. 2016. 5(1), 115-28.
Available from: https://www.uomustansiriyah.edu.iq/media/attachments/95/95_2016_07_04!11_05_46_AM.pdf.
Shakil M, Saleem DM, Zafar A, Ali A, Raziq M, Shams S. Clinical and hematological parameters in patients of Rheumatoid arthritis in a tertiary care hospital. Rawal Med. J. 2021; 46(1):45.
Available from: https://www.rmj.org.pk/fulltext/27-1588711248.pdf.
Xue L, Tao L, Sun H, et al. Association Between Blood PLT and RBC Related Indices and Disease Activity in Patients with Rheumatoid Arthritis. Int J Gen Med. 2022; 15:573-81.
Available from: https://www.ncbi.nlm.nih.gov/pubmed/35046715.
Padjen I, Ohler L, Studenic P, Woodworth T, Smolen J, Aletaha D. Clinical meaning and implications of serum hemoglobin levels in patients with rheumatoid arthritis. Semin Arthritis Rheum. 2017; 47(2):193-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28385457.
Fawzy RM, Said EA, Mansour AI. Association of neutrophil to lymphocyte ratio with disease activity indices and musculoskeletal ultrasound findings in recent onset rheumatoid arthritis patients Egypt. Rheumatol. 2017; 39(4):203-6.
Available from: https://www.sciencedirect.com/science/article/pii/S1110116417300571.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Dilan Saadaldeen Muhammed, Ranan Karadagh Polus, Nawsherwan Sadiq Mohammed
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in AMJ (The Scientific Journal of Kurdistan Higher Council of Medical Specialties )is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0)