The differences between manifestations of rheumatoid arthritis in men and women

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BackgroundRheumatoid arthritis (RA) is a chronic, multisystemic disease of unknown aetiology. The main feature of RA is a symmetric, additive inflammatory arthritis of small peripheral joints. The disease is more common in women. There is some evidence about the role of sex in pathogenesis and clinical features of RA.AimThe aim of this study is the recognition of the aspects of RA in female and male patients.MethodThis study includes the RA patients referred to the RA Research Clinic of Imam Hospital, Tehran, Iran, between 1998 and 1999 of which 160 were selected. One hundred and twenty-two were female and 38 male, showing a female to male ratio of 3: 1.ResultsThe mean age at the time of diagnosis of RA was 37 and 43 years in women and men respectively. The mean duration of disease before diagnosis was 8.8 years in women and 5.8 years in men. The indices of pain, limitation of movement and swelling of joints were higher in women, but only for the pain indices was the difference between the two sexes stastistically significant. No statistically significant difference in joint deformity was found between the two sexes but erosive joint lesions were more common in women. Involvement of the small joints of the upper limbs was more prevalent in women but hip and cervical spine involvement was more frequent in men. Considering extra-articular involvement, rheumatoid nodules, pulmonary and cardiac involvement and vasculitis was more prevalent in men but only for cardiac involvement was a statistically significant difference between the two sexes found. Rheumatoid factor was positive in 60% of both sexes. There was no statistically significant differences in lab tests and treatment strategy between the two sexes.ConclusionRA has a more severe course and worse prognosis in women; however, extra-articular involvement is more frequent in men.

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