- The Juntendo Medical Society
- 順天堂醫事雑誌 (ISSN:21879737)
- vol.66, no.1, pp.21-26, 2020 (Released:2020-02-29)
Rheumatoid arthritis (RA) is a chronic inflammatory disease that causes persistent inflammation, primarily in the synovial membrane of the joints. It may cause joint pain, swelling, and even deformation. Due to the strong involvement of abnormal immune function in its pathogenesis, RA is classified as a connective tissue disease. Most RA patients initially develop articular symptoms such as finger stiffness, pain, and swelling. They often visit medical institutions primarily complaining of these symptoms. However, it is known that manifestations of RA are found not only in the joints but also in a variety of organs in the entire body, including the lungs, skin, eyes, and blood vessels. These manifestations are called extra-articular manifestations, and they pose a problem as they significantly affect the patient’s activities of daily living (ADL), quality of life (QOL), and life expectancy. The pathology of RA has been elucidated in detail thanks to recent advances in molecular biology, and treatment strategies have undergone marked changes with the advent of biological drugs. Previously, the primary treatment goal was pain relief. Now, complete remission is becoming a reality with the prevention of bone destruction by completely inhibiting disease activity. However, extra-articular symptoms such as those involving the lungs pose major obstacles in drug selection for RA in many cases. When diagnosing and treating RA, it is important to not only evaluate articular manifestations but also accurately identify extra-articular manifestations and act appropriately.