In the clinic, many patients have many questions about rheumatoid arthritis, so today, I will answer some common questions for more patients.
1.Will rheumatoid arthritis cause long-term joint damage?
(1) What is rheumatoid arthritis, which joints are most often damaged, and what are the symptoms besides joint swelling and pain?
Rheumatoid arthritis is one of the most common clinical manifestations of rheumatic fever, which is an autoimmune disease that occurs after Group A, type B hemolytic streptococcal infection and causes connective tissue lesions throughout the body, mainly affecting the joints, heart, skin, but also the nervous system, blood vessels, plasma membranes, lungs, kidneys, etc. Thus, rheumatoid arthritis is associated with a metabolic reaction caused by group A hemolytic streptococci.
Rheumatoid arthritis most often involves large joints. Lower extremity joints are commonly seen, such as the knee and ankle joints are the most common, followed by shoulder, elbow and wrist joint involvement, while small joint involvement is less common. Joint symptoms may recur, and when local inflammation is evident, symptoms such as increased skin temperature and restricted movement may occur in addition to swelling and pain.
(2) How does this disease develop and is it caused by cold?
It is mainly caused by group A hemolytic streptococcal infection, and cold can be a causative factor for the onset of the disease, while the essence is group A hemolytic streptococcal infection.
(3) Which groups are susceptible to the disease?
People who are at high risk of developing the disease because of weak resistance or exposure to streptococci.
(4) Is the damage to the joints reversible and can the joints return to normal after treatment?
Rheumatoid arthritis usually leaves no disability after the joint inflammation subsides, and the joints rarely become dysfunctional or deformed.
(5) Is it possible for all patients with rheumatoid arthritis to get rheumatic heart disease?
The occurrence of rheumatic heart disease is generally related to the severity of rheumatic fever and preventive treatment, etc. The incidence decreases with age and is more common in children than in adults, with 65-80% of pediatric patients having cardiac involvement. Severe lesions or recurrent attacks can leave chronic heart valve disease.
2.Can patients with rheumatoid arthritis be cured with medication?
(1) What are the commonly used drugs for rheumatoid arthritis, how long can joint pain be improved, and how long can it be cured?
The common drugs for rheumatoid arthritis include two aspects: control of streptococcal infection, commonly used drugs such as penicillin; on the other hand, anti-rheumatic treatment, commonly used drugs such as salicylic acid preparations and glucocorticoids.
(2) Can I take hormones for rheumatoid arthritis and what symptoms should I take?
Glucocorticosteroids have strong and rapid anti-inflammatory effects, and are mainly used for patients with significant heart involvement, or where adequate salicylates are not effective.
(3) Is penicillin the most effective drug, how often does it need to be injected, and which drug can be switched to if I am allergic?
Penicillin is the drug of choice for streptococcal infections. Intramuscular injections of 400,000 to 800,000 U each time, twice daily, are preferred, usually for 10-14 days. Erythromycin can be given to those who are allergic to penicillin.
(4) How many times a day is aspirin taken, and which drug can be switched if gastrointestinal intolerance is present?
Aspirin should be taken 80-100mg/kg per day, with the maximum dose not exceeding 3-4g per day, in 4 oral doses. To reduce the gastrointestinal irritation of the drug, chew the tablets and swallow them. If you cannot tolerate it, you can use other NSAIDs.
(5) What are the other common side effects of taking the medication?
Prothrombin time and transaminases should be reviewed regularly while taking aspirin, and vitamin K may be added if there is a bleeding tendency.
(6) How often should I follow up during the medication?
Usually, it is necessary to check the relevant indexes 2 weeks after taking the medication. If the indexes are normal, the follow-up examination can be conducted monthly until the symptoms disappear.
(7) Is it possible to stop the medication when there are no symptoms and will the symptoms recur after stopping the medication?
In mild cases without cardiac involvement, the dose can be reduced by half after the symptoms disappear and the blood sedimentation is normal for 2 weeks, and the course of treatment is usually 6-12 weeks. Because the pathogenesis of the disease is still not completely clear, therefore, the possibility of relapse after discontinuation of the drug cannot be ruled out!