Study Of Hematological Profile In Rheumatoid Arthritis Patients

Abstract

Introduction Of the systemic lesions caused by rheumatoid arthritis, anemia and a focal subcutaneous granuloma are the most characteristic. Our aim is to study the hematological status in patients with rheumatoid arthritis and to find out the prevalence of anemia in these patients and its correlation with seropositivity and disease activity which is measured by DAS 28 score(Disease activity score). Methods: It is a cross-sectional prospective study using convenient simple random sampling of 44 patients attending the rheumatology clinic in Coimbatore medical college hospital over a period of one year. Results: Sex ratio of females to males is this study is 4:1. The risk of developing disease is greatest between 40 to 49 years. Rheumatoid factor positivity is 80% and rheumatoid factor negativity is 20%. The prevalence of anemia in rheumatoid arthritis patients is 75%. In rheumatoid factor positive patients mean Hb values is less (9.11gm %) compared to rheumatoid factor negative patients (10.23gm%). Iron deficiency anemia patients mean Hb is lower(8.6gm%) than in anemia of chronic disease is (10.9gm%). The prevalence of rheumatoid arthritis according to DAS 28 score categories in decreasing order are moderate 52.3% , severe 45.5% and mild 4.5%. Anemia is very well correlated with rheumatoid factor positivity, disease activity (DAS 28 score) ,duration of disease and ESR. Microcytic hypochromic anemia (iron deficiency anemia) is present in 25% of anemic patients and anemia of chronic disease (normocytic normochromic) anemia is present in 60% of anemic patients and dimorphic anemia in 15% anemic patients. Patients with anemia of chronic disease have higher disease activity (DAS 28 score) than iron deficiency anemia patients in rheumatoid arthritis. Rheumatoid factor, ESR, CRP and ferritin positively correlates with DAS 28 score significantly. Thrombocytosis is present in 31% of patients and eosinophilia is present in 27% of patients and very well correlated with DAS 28 score. Conclusion: The clinical and hematological profile of the patients with rheumatoid arthritis is studied. In this study, attempt has been made to analyze the risk factors and outcome of anaemia on the severity of rheumatoid arthritis based on the DAS28 score.