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The Association of Smoking with the Extra-Articular Manifestations in Rheumatoid Arthritis Patients

Authors: Mohammed Hadi Al-Osami --- Ali Abdul Majid Allawi --- Tahir Hussein Al-Saadawi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 1 Pages: 146-152
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية


ABSTRACT:BACKGROUND:Rheumatoid Arthritis (RA) is a chronic systemic autoimmune inflammatory disease that affect all ethnic groups throughout the world, the main characteristic symptom is persistent synovitis of diarthroidal joints often symmetrical resulting in pain, stiffness, and limitation of movement. Smoking is the most established environmental risk factor for development, severity,and extra-articular manifestation of RA..OBJECTIVE:To assess the association between smoking and appearance of extra-articular manifestation.PATIENTS AND METHODS:A cross sectional study was conducted on 244 patients with RA meeting the American College of Rheumatology Criteria for the classification of RA. Patients data were obtained via face - to- face interview performed by rheumatologist. RA disease-related data, such as disease duration, drug use (all anti-rheumatic drugs , glucocorticoid use and NSAID's), history of smoking which is classified into current smoker, former Smoker ( patient discontinue smoking for at least three months ), and never smoker , also number of cigarette per day were also recorded.Extra-articular manifestation of RA were assessed in all patient by thorough physical examination, and the patient send for appropriate investigation to confirm the diagnosis. RESULTS:Among 244 patients with RA, 76.2% were women and 23.8% were men, the females were significantly predominate the study samples (P<0.001). The mean (SD) age are 46.9 ± 11.4, the age varies with smoking history (P=0.043). It is significant to find that two third of patients (69.3%) not have smoking history (P<0.001) because majority of patients were female.Smoking is significantly increase rheumatoid factor positivity (P=0.013), Smoking is significantly associated with rheumatoid nodules (P<0.001), secondary Sjögren syndrome (P<0.001), and eye involvement (P=0.002), while there is no significant association with other extra-articular manifestations.. CONCLUSION:There is significant association between smoking and RA extra-articular manifestations

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