Predictors of Mortality in Severe Leptospirosis

ABSTRACT

Introduction: Rheumatoid arthritis (RA) is a chronicmultisystem disease of unknown cause. The characteristicfeature of RA is persistent inflammatory synovitis usuallyinvolving the peripheral joints in a symmetric fashion.Hence;the present study was undertaken for assessing rheumatoidfactor titers in extra-articular manifestation of rheumatoidarthritis.Material and methods: A total number of 50 patientswho met the inclusion criteria were included in this study.Rheumatoid arthritis diagnosed as per 2010 revised criteriafor the classification of RA were enrolled. The RA patientsthus selected were screened for various common clinicalfeatures, articular and extra-articular manifestations usinga structured Proforma designed for this study. At the end ofthe study the titers of RF factor in articular and extra articularmanifestations in 50 rheumatoid arthritis patients screenedwere calculated and expressed as percentage. All the resultswere recorded in Microsoft excel sheet and were analysed bySPSS software.Results: The clinical examination in the study revealedpallor in 34(68%) patients. Rheumatoid factor titres of 116were observed in 4(13%) of patients, 132 in 7(24%), 164 in8(28%) and 1;128 in 10(35%) of patients. Hemoglobin <8g/dl in 10 patients i.e.;(20%), 8-10g/dl in 14 patients i.e;40%,10-12g/dl in 10 patients i.e.; 28%. (Normal Hb 12-14g/dlin females, 14-16g/dl in males). Peripheral smear showed24 patients i.e 70% of them had normocytic normochromicanemia. Extra-articular manifestations were seen in about72%, Anemia in 34(68%), Lymphadenopathy in 8(16%),Purpuric –rash in 4(8%), Rheumatoid nodules in 4(8%) andSplenomegaly in 2(4%).Conclusion: Extra-articular manifestations contributesignificantly to the morbidity and mortality in rheumatoidarthritis. Careful screening of all patients for extra-articularmanifestations may help reduce the same, with the propermanagement of such patients