Artritis reumatoide

Abstract

Rheumatoid arthritis is a chronic, multisystem autoimmune disease. Its etiopathogenesis is complex; it has been linked to a breakdown of immune system tolerance favored by genetic and environmental factors. The disease course runs from predisposition through a situation of autoimmunity to the onset of non-visible joint symptoms and finally reaching clinical expression as persistent synovitis. Although the main manifestation is joint involvement in the form of symmetrical polyarthritis of the hands and feet, it can also affect other organs. Its most common extra-articular manifestation is rheumatoid nodules. Nonetheless, interstitial pulmonary involvement is of particular importance, as it the second leading cause of death after cardiovascular events. It is frequently associated with comorbidities such as cardiovascular risk, infections, cancer, and osteoporosis, whose evaluation and treatment must form part of these patients’ management. It is diagnosed through a combination of clinical features, characteristic laboratory findings such as the presence of rheumatoid factor and/or anti-cyclic citrullinated peptide antibodies, and imaging tests. Although mortality is decreasing thanks to advances in recent decades, patients with rheumatoid arthritis continue to have a high disease burden and a significant decline in quality of life.