Palindromic Rheumatoid Arthritis
Palindromic rheumatoid arthritis has much similarity in symptoms and appearance with rheumatoid arthritis, but is different in that, it hardly causes permanent joint damage. Recurring attacks of pain and swelling in the joints of knees, fingers and large joints are the main characteristics of the disease. Nodules, quite same as those produced in RA, are produced on the affected joints, which usually a rheumatologist can identify and does further testing to confirm the presence of palindromic RA. The patient may or may not suffer from weakness and fever, during the repeated flares which make the joints swollen and painful and are, therefore, often confusing the disease with rheumatoid arthritis. It occurs equally in men and women, unlike RA, which occurs more prominently in women. Also, it can occur at any age between 20 and 70; however, the disease as such is rare.
Though in 40% patients of palindromic arthritis, the attacks become more frequent, x-rays of the affected joints do not generally show any narrowing of joints, which occurs in RA. A very less percentage of sufferers develops a full-scale rheumatoid arthritis from palindromic arthritis and may test positive also for the rheumatoid factor.
The patients of palindromic arthritis may show high sedimentation rates during blood tests and also may show high levels of C-Reactive Protein in the blood. Some studies have inferred the connection of anti-malarial drugs, like Plaquenil, to high risk of developing palindromic arthritis, which later develops into full-scale rheumatoid arthritis.
Diagnosis of palindromic rheumatoid arthritis is difficult and may take time. It is usually based on elimination of other conditions and finally concluding about the occurrence of the disease. This is because there is no specific test for the diagnosis of this disease. Also it becomes more difficult with the possibility of presence of other auto-immune diseases. However, it is interesting to note that presence of rheumatoid factor indicates high chances of developing rheumatoid arthritis in future.
The flares of palindromic rheumatism may last from a few hours to a few days and then suddenly subside and may not show for a long time. They form a pattern with the symptom-free periods. More commonly 2 to 3 joints are involved and the soft tissue surrounding the joints may also be involved with swelling at particular spots. Particularly finger pads and heel pads are affected.
This is a disease caused by unknown factor. An opinion says that it is an abortive form of RA, indicated by the raised levels of antikeratin antibodies (AKA) and anti-cyclic citrullinated peptide antibodies (anti-CCP), which is the characteristic of rheumatoid arthritis.
Initial treatment includes pain-killers and anti-inflammatory drugs. The physician may also start an anti-depressant. As the attacks are highly unpredictable, the treatment is quite difficult. If the attacks are very frequent, long-term treatment with the disease-modifying anti-rheumatoid drugs (DMARDs), which is administered in rheumatoid arthritis patients, may have to be started.
To adopt a diet, free of pain-causing prostaglandins and arachidonic acid, may help quite a lot. It includes lots of vegetables, fruits, cold water fish, nuts and soy products. It is a must to keep away from weight-gaining foods and oils containing omega-6 fatty acids, namely, sesame oil, sunflower oil, corn oil, wheat germ oil and soybean oil. Palindromic rheumatoid arthritis is thus a disease which rarely causes any harm and you have to manage the pain attacks, by which it is characterized.