Misra Durga Prasanna
Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow - 226014, India.
Best Pract Res Clin Rheumatol. 2025 Mar;39(1):102020. doi: 10.1016/j.berh.2024.102020. Epub 2024 Nov 2.
Symmetric inflammatory polyarthritis is the most prominent manifestation of rheumatoid arthritis (RA). However, RA can practically affect any organ system, whether hematologic, neurological, cardiac, lung, skin, eyes, or kidneys. Systemic involvement in RA can be severe when there is interstitial lung disease, scleritis, amyloidosis, pure red cell aplasia, or myelodysplasia. Cardiovascular disease is the leading cause of death in patients with RA with a similar cardiovascular risk to that with diabetes mellitus. Patients with RA are at an increased risk of infections or osteoporosis, largely due to treatment-related etiologies. Rheumatoid vasculitis is a devastating long-term complication of RA which is fortunately becoming rarer over time due to better disease activity control. While the risk of mortality overall seems to be reducing over time, the excess mortality risk with RA compared with the general population persists. Fibromyalgia, anxiety, depression, fatigue, and physical inactivity remain important comorbidities associated with RA.
对称性炎性多关节炎是类风湿关节炎（RA）最突出的表现。然而，RA实际上可累及任何器官系统，无论是血液系统、神经系统、心脏、肺、皮肤、眼睛还是肾脏。当出现间质性肺病、巩膜炎、淀粉样变性、纯红细胞再生障碍或骨髓发育异常时，RA的全身受累可能很严重。心血管疾病是RA患者的主要死因，其心血管风险与糖尿病患者相似。RA患者感染或骨质疏松的风险增加，主要是由于与治疗相关的病因。类风湿血管炎是RA一种严重的长期并发症，幸运的是，随着疾病活动控制得越来越好，这种并发症正变得越来越少见。虽然总体死亡率风险似乎随着时间的推移而降低，但与普通人群相比，RA患者的额外死亡风险仍然存在。纤维肌痛、焦虑、抑郁、疲劳和身体活动不足仍然是与RA相关的重要合并症。
