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ISSN: 2161-1149

Rheumatology: Current Research
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Case Report

Early Inflammatory Polyarthritis: Case Study

Morelia Nuñez-Sotelo1, Luis Arturo Gutierrez-Gonzalez1*, Nancy Gonzalez2 and Benito Losada1

1Centro Nacional de Enfermedades Reumáticas (CNER), Hospital Universitario de Caracas, Caracas, Venezuela

2Cátedra de Salud Pública, Universidad Central de Venezuela, Caracas, Venezuela

*Corresponding Author:
Luis Arturo Gutiérrez-González
Centro Nacional de Enfermedades Reumáticas (CNER)
Hospital Universitario de Caracas
Urbanización Los Chaguaramos
Ciudad Universitaria, UCV
Caracas 1020, Venezuela
E-mail: [email protected]

Received date: May 13, 2012; Accepted date: August 04, 2012; Published date: August 10, 2012

Citation: Nuñez-Sotelo M, Gutierrez-Gonzalez LA, Gonzalez N, Losada B (2012) Early Inflammatory Polyarthritis: Case Study. Rheumatol Curr Res 2:109. doi: 10.4172/2161-1149.1000109

Copyright: © 2012 Nuñez-Sotelo M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

To determine which patients with early inflammatory polyarthritis (EIP) with less than a year of evolution of the disease without a definitive diagnosis, progressed to rheumatoid arthritis according to ACR1987 criteria, we developed a predictive model for classification of early rheumatoid arthritis, based on clinical characteristics by observation of the onset of the disease and to relate with certain laboratory variables. A total of 54 patients with arthritis of less than one year of evolution were evaluated. We conducted a physical examination and the following parameters were determined: DAS 28, HAQ, rheumatoid factor (RF), citrullinated peptide (anti-CCP) and c-telopeptide (CTx-II); radiology of hands and feet was also carried out, and was assessed by the Sharp method modified by van der Heijde. The patient follow-up was performed every3 months for 12 months, classifying them according to the development of self-limiting, persistent non-erosive, and persistent erosive arthritis, and according to definite diagnosis. We estimated the relative risk and 95% confidence intervals for the predictor variables considered. Overall, 80.4% of patients with EIP evolved to persistent arthritis. Most persistent arthritis was diagnosed as rheumatoid arthritis (67.4%). A positive serology in patients with rheumatoid arthritis was 70% for RF, 61.5% for anti-CCP and 61% for CTx-II. The basal nodes and RF were able to predict the persistence of activity and symmetry; rheumatoid nodules predict the development of erosions. An initial erosive disease increases the risk of radiological progression.

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