Al-Ghamdi Aisha, Attar Suzan M
Departments of Internal Medicine and Rheumatology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
Ann Saudi Med. 2009 May-Jun;29(3):189-93. doi: 10.4103/0256-4947.51774.
The frequency of extra-articular manifestations in rheumatoid arthritis (ExRA) differs from one country to another, so we investigated ExRA frequency in a well-defined hospital patient population with rheumatoid arthritis (RA) in Saudi Arabia. We also examined possible predictors of the development ExRA.
A retrospective analysis was conducted of all patients diagnosed with RA at a university hospital during a 4-year period. Cases were classified according to the 1987 American College of Rheumatology criteria for RA, and the frequency of ExRA was recorded.
Of 140 patients who fulfilled the criteria for the diagnosis of RA, 98 (70%) developed ExRA features. Anemia occurred in 61%, thrombocytosis in 16%, pulmonary involvement in 10%, and renal amyloidosis, vasculitis and Felty syndrome were present in 6%, 2% and 1%, respectively. The mortality rate was high (16%) in patients with ExRA. The predictors for mortality were lung involvement, age over 50 years and kidney amyloidosis.
ExRA were present in a substantial proportion of our patients, which lead to a worse disease outcome. Anemia, thrombocytosis and respiratory system involvement were the commonest. Early recognition and treatment are important to decrease mortality.
类风湿关节炎关节外表现（ExRA）的发生率在不同国家有所差异，因此我们调查了沙特阿拉伯一家定义明确的医院中类风湿关节炎（RA）患者的ExRA发生率。我们还研究了ExRA发生的可能预测因素。
对一所大学医院4年间所有诊断为RA的患者进行回顾性分析。病例根据1987年美国风湿病学会RA标准进行分类，并记录ExRA的发生率。
在140例符合RA诊断标准的患者中，98例（70%）出现ExRA特征。贫血发生率为61%，血小板增多症为16%，肺部受累为10%，肾淀粉样变性、血管炎和费尔蒂综合征分别为6%、2%和1%。ExRA患者的死亡率较高（16%）。死亡的预测因素为肺部受累、年龄超过50岁和肾淀粉样变性。
我们的患者中有相当一部分存在ExRA，这导致了更差的疾病结局。贫血、血小板增多症和呼吸系统受累最为常见。早期识别和治疗对于降低死亡率很重要。
