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International Journal of Clinical Case Reports 2014, Vol. 4, No. 3, 1-4
http://ijccr.biopublisher.ca
1
Can New Diagnostic Criteria of Rheumatoid Arthritis Really Do An Early
Diagnosis? -A Case Report of Early Diagnosis and Treatment of Rheumatoid
Arthritis with Traditional Medicine
Yanjun Kong
1
, Qiande Zhang
2
, Muxin Wei
3
1. Department of Chinese Internal Medicine and Institute of Integrated Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing
210029, Jiangsu Province, China
2. Department of rheumatism, Institute of Integrative Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu
Province, China
3. Department of Chinese Internal Medicine and Institute of Integrated Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing
210029, Jiangsu Province, China
Corresponding author email:
weimuxin@njmu.edu.cn
,
International Journal of Clinical Case Reports, 2014, Vol.4, No.3 doi: 10.5376/ijccr.2014.04.0003
Received: 10 Mar., 2014
Accepted: 28 Mar., 2014
Published: 7 Jun., 2014
© 2014 Kong et al. This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Kong et al., 2014, Can New Diagnostic Criteria of Rheumatoid Arthritis Really Do An Early Diagnosis? -A Case Report of Early Diagnosis and Treatment of
Rheumatoid Arthritis with Traditional Medicine, International Journal of Clinical Case Reports, Vol.4, No.3, 1-4 (doi: 10.5376/ijccr.2014.04.0003)
Abstract
Rheumatoid arthritis (RA) is a chronic systemic disease in which immunologically mediated inflammation of
synovia-lined joints can result in marked disruption of joint structure and function. In Traditional Chinese Medicine (TCM), it
belongs to "Be Syndrom", the outcome of the struggle between body resistance and pathogenic factors. RA is a highly disabling
disease of which untreated patients show about 50% disability in two years. One cause of the high morbidity of RA is the long
latency from the onset of symptoms to the definitive diagnosis of RA and the initiation of appropriate treatment. The difficult to
make diagnoses of early RA since the early manifestations were atypical and the lack of specific diagnostic methods. This case is
about the effectiveness of TCM treatment of patients with early RA which is reflected in both the diagnosis part and the treatment
process. The patient in this case , Male, 56 years old, had been diagnosed of RA by TCM almost ten years earlier than that his
symptoms could reach the Western diagnostic requirements. The important role of preventive thought -"preventive treatment of
diseases"- in TCM in the early diagnosis and treatment of RA needs to be emphasized. It can be a practical way to treat RA with
early TCM diagnose and treatment that impact disease activity and ultimately have been shown to slow or arrest structural joint
damage, and then turn up to Western medicine treatment if the patient's symptoms reach the Western diagnostic requirements.
Keywords
Rheumatoid arthritis; Early diagnosis; Traditional chinese medicine; Case report
Introduction
Rheumatoid arthritis (RA) is a chronic systemic
disease in which immunologically mediated
inflammation of synovia-lined joints can result in
marked disruption of joint structure and function. With
advances in our understanding of the pathogenesis of
RA over the past two decades, emphasis has shifted to
intervention early enough in the disease course to
prevent the joint destruction that follows inflammation.
Accordingly, in 2010 the ACR and the European
League Against Rheumatism (EULAR) put forward
revised classification criteria emphasizing RA
characteristics that emerge early in the disease course,
including ACPAs, a biomarker that predicted
aggressive disease. These were in contrast with the
1987 ARA criteria, which distinguished established
RA patients from those with other forms of arthritis,
and identified patients with later disease. The
categories of the 2010 ACR/EULAR criteria were
grouped into four classifications, with point scores for
each: joint symptoms; serology (including RF and/or
ACPA); symptom duration, whether <6 weeks or >6
weeks; and acute-phase reactants (CRP and/or ESR)
(Jonathan et al., 2012).
But for the early RA with no typical symptoms, such
as the patient in the following case, it still only has a
quite limited diagnostic value. Treatment for RA has
changed profoundly over the past 25 years, evolving
from a strategy of providing symptomatic relief, to
implementation of therapeutic regimens that impact
disease activity and ultimately have been shown to