Clinical and laboratory parameters associated with anemia in rheumatoid arthritis patients

Abstract EN

Objective: To describe the causes of anemia associated with Rheumatoid Arthritis and to assess the relationship of anemia with a set of parameters covering clinical and serological status.

Methods: This is a retrospective study from January 2016 to June 2016.

Adult patients diagnosed with Rheumatoid Arthritis (RA), who were treated in outpatient department at both Rheumatology/Rehabilitation and General Medicine clinics at Prince Rashid hospital in Irbid –Jordan, were included.

The collected data of study were gender, age at diagnosis, duration of disease, level of disease activity, medication history and lab investigations (including full hematologic indices, Chemistry, and serological markers for rheumatoid arthritis).

In anemic patient's further investigation were done to reveal the cause and type of anemia.

The WHO definition of anemia was used.

Results: A total of 87 patients with RA were included in the study, 72(82.75%) were females and 15(17.25%) were males with a ratio of (5:1).The average duration of disease before the beginning of our study was 11 years.

The mean value for the Disease Activity Score 28 (DAS28) was 4.2 ± 1.64 which puts most patients in the moderate to severe group of disease activity.

patients had mean hemoglobin level of 11.67 (SD±1.8 g/dl) with females having a mean haemoglobin of 11.4 (SD±1.58 g/dl), and 12.86(SD ±2.38 g/dl) in males.

The prevalence of anemia was 56% (49 patients).

Anemia among female patients were more frequent than in male patients (61% vs.

33%, p=0.04).

Characteristics of anemic patients were: being female, having longer history of the disease, higher number of disease modifying anti-rheumatic drugs use, Lower B12 level and higher Disease Activity Score .

The mean ESR, CRP, Creatinine levels were significantly increased in the anemic when compared with the non-anemic group.

Conclusion: Anemia in RA has many causes and complete evaluation is necessary for diagnosis and therapeutic management.

Treatable causes were commonly identified.

Our study clearly illustrates that more than half of patients with RA had anemia and anemia of chronic diseases (ACD) was the most common type.

It is also concluded that patients with anemia tend to have more severe disease than patients without anemia.