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Rheumatism
Connective Tissue Diseases & Rheumatoid Arthritis – The Staged Multimarker Concept
Pain in joints and muscles, stiff knees, back pain, swollen and red joints comprise the typical symptoms associated with the generic term "rheumatism". A total of about 450 different diseases are grouped together under this term. Their commonality is pain. In Germany about 20 million people suffer from the various forms of this disease.
Rheumatic diseases can affect joints and/or the connective tissue. Because of the incredible diversity of rheumatic diseases these are divided into two major groups:
¤ Connective tissue diseases.
¤ Rheuma / rheumatism.
The classification presented here is only one possible structuring, but is widespread. However, the nomenclature and classification of rheumatic diseases are not uniformly regulated.
Connective Tissue Diseases
Connective Tissue Diseases are a group of rare autoimmune diseases in which the immune system recognizes parts of the body's connective tissue (collagen) as foreign, and initializes antibody production against them. Since the connective tissue is of mayor importance in many different organs,collagenosis often occurs in many organs at once, such as the skin, mucous membranes, lungs, heart or blood vessels - all of which are attacked simultaneously.
The disease course is usually chronic and can affect all physiological aspects of the afflicted patients. Women are diagnosed much more frequently than men, and the disease usually occurs in middle age.
Rheumatoid Arthritis – The Staged Multimarker Concept
An early diagnosis of rheumatoid arthritis (RA) can prevent the loss of mobility and the destruction of the joints. The usual serodiagnosis of RA (rheumatoid factor and CRP) alone is not sufficient, however, since rheumatoid factors are unspecific (and may also be evidence of other autoimmune disorders and infections). On the other hand, antibodies against cyclic citrullinated peptide (CCP) are almost exclusively present in patients with rheumatoid arthritis (specificity up to 98%). Up to 30% of early RA patients are RF and / or CCP seronegative.
Here the detection of anti-RA33 antibodies allows the diagnosis of these patients and may permit a mild disease course with less damage to joints.
Regardless of anti-CCP and RF, anti-RA33 antibodies are present in the early phase of RA and can be recognized years before the clinical onset of the disease. A combined diagnosis with three serological markers offers optimal diagnostic sensitivity.
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