Friday, November 2, 2012

Repair mechanisms at work in Rheumatoid Arthritis?

We discussed the findings of the following patient.
Mrs. Ch. G. was born in 1961 and diagnosed as suffering from rheumatoid arthritis in 2007, with already experiencing aches and pains for several years. We’ve seen her last year for the first time. Rheumatoid factor has been measured at about 200 IU/ml, lately at 130 IU/ml, CRP dropped from 18.7 to 4.8 mg/l, ESR from 50 to 19 mm. CCP antibodies measured 61 IU/ml. Last DAS28 showed remission. She had been treated with methotrexate from 2007 to the beginning of 2011. After a pancreatitis no one dared to re-expose her to methotrexate. About 1 ½ years ago we established a combination of sulphasalazine and hydroxycholoquine. Now, have a look at the X-ray charts of her feet:

After methotrexate and before sulphasalazine and hydroxychloroquine

After sulphasalazine and hydroxycholoquine for over a year
We think that this rather unspectacular combination of conventional DMARDs lead to repair mechanisms.

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