J Korean Rheum Assoc.
2006 Dec;13(4):291-298.
Clinical Characteristics of Late-onset Rheumatoid Arthritis
- Affiliations
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- 1Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. sookonlee@yumc.yonsei.ac.kr
Abstract
OBJECTIVE
Late-onset rheumatoid arthritis (LORA) refereed as the subset of rheumatoid arthritis with age of onset over 60 years old, seems to differ from younger onset disease (YORA) by more equal sex distribution, a higher frequency of abrupt disease onset, more large joints involvement, more extraarticular manifestation, erythrocyte sedimentation test (ESR), and less rheumatoid factor (RF) positivity. We need data of LORA in Korea because of lack of data.
METHODS
Two hundred and forty-two patients were studied retrospectively. We compared the difference with clinical manifestation, disease activity markers, RF, ANA, and radiologic changes between LORA and YORA. Sums of ESR and C-reactive protein (CRP) during first year after diagnosis were calculated through area under curve. Radiologic joint damages were evaluated using modified Sharp score.
RESULTS
The gender ratio (female/male) was 1.54 in LORA and 6.43 in YORA (p<0.001). The duration of the diagnosis was longer in LORA than in YORA (25.2+/-27.0 months, 18.5+/-22.2 months, p=0.048). Tender and swollen joint, and involvement of joints were not different in the groups. ESR, CRP, platelet, and RF were higher with LORA. Sums of ESR and CRP were higher in LORA than in YORA (403.7+/-252.2 mm/hr, 25.6+/-41.1 mg/dL vs 281.4+/-201.3, 12.0+/-15.0). There was no difference of modified Sharp score in both groups.
CONCLUSION
The LORA has an equal gender ratio, longer morning stiffness and disease duration, and higher levels of RF, platelet, ESR, CRP, and summation of ESR and CRP, which suggests that LORA may have poorer prognosis than YORA.
