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류마티스관절염에서 치료 시기가 질병 활성도 및 관절 손상에 미치는 영향
길지훈 ( Jee Hoon Ghil ),정세진 ( Se Jin Jung ),최상태 ( Sang Tae Choi ),강은진 ( Eun Jin Kang ),이상원 ( Sang Won Lee ),박민찬 ( Min Chan Park ),박용범 ( Yong Beom Park ),이수곤 ( Soo Kon Lee ) 대한류마티스학회 2006 대한류마티스학회지 Vol.13 No.4
Objective: We investigated the effect of the early diagnosis and treatment on the disease activity and joint damage in patients with rheumatoid arthritis (RA). Methods: We enrolled 242 RA patients (male 50 patients, female 192 patients, mean age 49.7±13.5 years old) in this study. They were divided into two groups according to lag-time to diagnose RA from the onset of symptoms. 136 RA patients whose lag-time did not exceed 12 months were classified into early diagnosed RA group and 106 RA patients whose lag-time over 12 months were classified into delayed diagnosed RA group. Baseline date were assessed at the time of diagnosis. Disease activity was assessed by sums of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) during first year after diagnosis. Radiological joint damages were evaluated using modified Sharp score. Results: At the time of diagnosis, the age of patients, ESR and platelet counts were significantly decreased, and hemoglobin level was significantly increased in early diagnosed RA group. Early diagnosed RA group showed lower sums of ESR and CRP than delayed diagnosed RA group significantly. Modified sharp score at the time of diagnosis and after treatment were significantly lower in early diagnosed RA group than delayed diagnosed RA group. The difference of modified sharp score between at the time of diagnosis and after treatment were lower in early diagnosed RA group than delayed diagnosed RA group too. Conclusion: The early diagnosis and treatment of RA reduced extent of joint damage and provoked better response to treatment significantly.
정세진 ( Se Jin Jung ),길지훈 ( Jee Hoon Ghil ),윤기태 ( Ki Tae Yoon ),송경호 ( Kyung Ho Song ),장현 ( Hyun Chang ),전성하 ( Seong Ha Cheon ),정종열 ( Jong Yul Jung ),이찬희 ( Chan Hee Lee ),박용범 ( Yong Beom Park ),이수곤 ( Soo 대한류마티스학회 2006 대한류마티스학회지 Vol.13 No.3
Focal myositis is an uncommon benign inflammatory myopathy of unknown cause affecting skeletal muscle, and presenting as a localized painful swelling within the soft tissue of an extremity. According to some reports, focal myositis may occur in patients with rheumatoid arthritis, sarcoidosis, and other connective tissue diseases. To our knowledge, there has been no case report of focal myositis associated with rheumatoid arthritis. We report first case of focal myositis in a patient with rheumatoid arthritis.
정세진 ( Se Jin Jung ),길지훈 ( Jee Hoon Ghil ),최상태 ( Sang Tae Choi ),강은진 ( Eun Jin Kang ),이상원 ( Sang Won Lee ),박민찬 ( Min Chan Park ),박용범 ( Yong Beom Park ),이수곤 ( Soo Kon Lee ) 대한류마티스학회 2006 대한류마티스학회지 Vol.13 No.4
Objective: Late-onset rheumatoid arthritis (LORA) refereed as the subset of rheumatoid arthritis with age of onset over 60 years old, seems to differ from younger onset disease (YORA) by more equal sex distribution, a higher frequency of abrupt disease onset, more large joints involvement, more extraarticular manifestation, erythrocyte sedimentation test (ESR), and less rheumatoid factor (RF) positivity. We need data of LORA in Korea because of lack of data. Methods: Two hundred and forty-two patients were studied retrospectively. We compared the difference with clinical manifestation, disease activity markers, RF, ANA, and radiologic changes between LORA and YORA. Sums of ESR and C-reactive protein (CRP) during first year after diagnosis were calculated through area under curve. Radiologic joint damages were evaluated using modified Sharp score. Results: The gender ratio (female/male) was 1.54 in LORA and 6.43 in YORA (p<0.001). The duration of the diagnosis was longer in LORA than in YORA (25.2±27.0months, 18.5±22.2 months, p=0.048). Tender and swollen joint, and involvement of joints were not different in the groups. ESR, CRP, platelet, and RF were higher with LORA. Sums of ESR and CRP were higher in LORA than in YORA (403.7±252.2 mm/hr, 25.6±41.1 mg/dL vs 281.4±201.3, 12.0±15.0). There was no difference of modified Sharp score in both groups. Conclusion: The LORA has an equal gender ratio, longer morning stiffness and disease duration, and higher levels of RF, platelet, ESR, CRP, and summation of ESR and CRP, which suggests that LORA may have poorer prognosis than YORA.