Rheumatoid arthritis systematic disease with extraarticular manifestations in a 20 year old female presenting with fever a case report / Joyce B. Tan.

Includes bibliographical references.

ABSTRACT: Rheumatoid Arthritis (RA) is a form of systemic disorder and is the most common form of chronic inflammatory polyarthritis. Systemic manifestations of RA can be due to release of inflammatory effector molecules from the synovium, which leads to active RA, manifested as malaise, fatigue, with elevated serum acute phase reactants. Rheumatoid Factor (RF) is preent in approximately 70 percent of patients; it is also detected in other diseases. The objectives of this case report is to present a case of a 20 year old female who have relapse of Rheumatoid Aethritis, who presented with fever, and to discuss a case of Rheumatoid Arthritis in Flare complicated with pleuropericardial effusion, its pathophysiology, prognosis and management. We are presented with a case of 20 year old, female, diagnosed with Rheumatoid Arthritis for 3 years, with a chief complaint of fever for 14 days. She was tachycardic, tachypneic and febrile upon initial presentation at the emergency room, with palpable tender movable matted suupraciavicular lymph nodes, measuring 2x3 cm at the left supraclavicular area, with intercostal retractions, decrease vesicular breath sounds, tactile and vocal fremitus, flat upon percussion on left lower lung field, and crackles on rigth lower lung field, with swelling of the left and rigth knee and elbow joints which are warm to touch. Therapy aims in controlling the underlying inflammation, and pericardiocentesis is only usually indicated in evidence of cardiac tamponadde. Several immunolodulating drugs are still under study, whether they are effective in some way in the suppression of the different mechanism underlying the pathophysiology of Rheumatoid Arthritis, thus, further studies are recommended, especially on the therapeutic approach of this disease entity.

Research - Department of Medicine