Rheumatology, Vol 38, 668-674, Copyright © 1999 by British Society for Rheumatology
C Turesson, L Jacobsson and U Bergstrom
OBJECTIVE: The prevalence and distribution of extra-articular
manifestations of rheumatoid arthritis (ExRA) and associated mortality were
studied retrospectively in a cohort of RA patients admitted to University
Hospital, Malmo, Sweden, during the period 1990-94. RESULTS: Of 489
patients who fulfilled the 1987 ACR criteria for RA, 37 manifested onset of
ExRA, predominantly serositis and cutaneous vasculitis, during the period,
corresponding to a cumulative incidence of 7.9%. The occurrence of ExRA was
independent of disease stage. Among patients with ExRA, 1 death/4.3
person-years at risk (pyr) occurred, as compared with 1 death/11.4 pyr in
the non-ExRA subgroup. The age- and sex-adjusted mortality rate ratio was
2.49 (95% confidence interval 1.43-4.03). The major cause of death among
ExRA cases was heart disease, which occurred in 9/13 cases (69%) in
comparison to the expected 2.4 cases. CONCLUSION: In this series, serositis
and cutaneous vasculitis were predominant extra-articular manifestations of
RA; and mortality was greater in the ExRA than in the non-ExRA subgroup,
perhaps due to a high frequency of associated heart disease.
ORIGINAL PAPERS
Extra-articular rheumatoid arthritis: prevalence and mortality
Department of Rheumatology, Lund University, University Hospital, Malmo, Sweden.
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