The definition of patients with early arthritis in cilinical and laboratary aspects and the effect of initial laboratary valves to the prognose

Purpose: Early arthritis is the period when the clinical and radiological damages are not seen. Although the duration of this period is not definite, the duration of symptom is considered as two and less than two years. Early arthritis is mostly related to rheumatoid arthritis. RA is a systemic disease whose etiology is not known, which shows its characteristic features mostly in peripheral joints, and which continues as chronically, progressively, erosive, and which is the most common one among the autoimmune inflammatory arthritis. The disease decreases the quality of life by causing severe deformities and disabilities and it causes early deaths. It has been shown that the joint damage can be stopped by the early diagnose and treatment of the disease. Therefore, most of the recent studies have been focused on diagnosing and early treatment of this disease which has severe results. In our study, we aimed to clarify the clinical and laboratory definitions, diagnostic durations-delaying duration, the reasons of diagnosing delays of the early arthritis patients who has applied to our Rheumatology and Immunology Center.Material and Method: In our prospective study 112 early arthritis patients 70 of whom were RA patients and a control group of 31 patients who were resistant to DMARD treatment were included. The patients? initial symptom, symptom duration, morning stiffness, delivery and predilection of the extremities, comorbidity, the history of family, smoking, and the drug using were investigated. At the initial visit CRP, ESR, anti-CCP, ANA, and CBC were studied and hand graphics were scored. Patients were followed by minimum one maximum two years. At least at the first year of the treatment, the control anti-CCP and RF levels were studied.Results: The disease mostly onsets in upper extremities in a chronic, polyarthritis and symmetric way. 52.9% for RF, 65.7% for anti-CCP, 15.7% for ANA, 64.3% for CRP, and 72.9% for ESR positivity and 64.3% for radiologic damage of the patients were found in our study. The delay of diagnose is averagely 21 weeks and generally it is due to the late applying of the patients. At the first year of the treatment the decrease of 64.5% for RF and 11.4% for anti-CCP were detected.Conclusion: Anti-CCP, RF, smoking, CRP, ESR, the onset of the disease in polyarthritis and upper extremity, and being more than one hour of morning stiffness increase the radiologic damage, but the disease?s being chronic onset and the late diagnose of the disease more than 3 months are most important reasons of radiologic damages. The late diagnose of the disease more than 3 months increases the radiologic damage 4.5 times.Key Words: Early arthritis, rheumatoid arthritis, auto antibodies, 2010 EULAR/ACR classification criteria for RA