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What Is The Long Term Prognosis For Rheumatoid Arthritis?
Question: Hi Doctor,
My sister is 24 years old, few weeks ago she was diagnosed with Rheumatoid Arthritis.
Her complain started about 4 months ago, when she developed a slight swelling in her wrists and some pain in her toes and fingers, but after sometime the pain disappeared suddenly, until few weeks ago the pain returned so we decided to go to a rheumatologist.
He did several blood tests such as
liver,kidney function tests, CBC
Vitamin d test
he also took RF factor test and anticcp test.
after the results came out, he said that all other blood test are normal except she has iron and vitamin D deficiency, the RF test was Rhematoid factor was also normal however he saw a very high Anti-ccp which was 10,835 U/ml (ten thousand +) . and it's normal level is from 0-17 U/ml,
He suggested to confirm Rheumatoid arthritis by doing more specific test which is
1-Antinuclear antibodies
2-RF factor IGG
3-RF factor IGM.
the results showed positive for Rheumatoid arthritis.
The doctor said, that currently the symptoms seems not very severe and it's good that we brought her earlier to the hospital. he gave her the following medicines for Anaemia,VitD deficiency and Rheumatoid arthritis.
1-Easy Iron Caps 30's (Twice daily)
2-Euro D 10000 IU Caps 30's (each other day)
3-Solumedrol 125mg ING (one time on the hospital day to reduce inflammation immediately)
4- Methotrexate 2.5mg Tab (4 pills one time every week).
5- Plaquenil 200mg XXXXXXX 60's (one perday)..
He said to not take methotrexate and easy iron on the same day, when taking methotrexate we should wait atleast two days and on third day take the easy iron tabs..
my questions..
1-What's the prognosis of Rheumatoid artheritis? is it fully treatable/reversible?
2-I read that methotrexate can cause infertility in male and female taking it should stop if they are planning to be pregnant ?
does it also cause infertility in female? if so is there a better alternative than methotrexate she can use?
3- The doctor said we have to go to him every 2 weeks to do other tests and then every month and then every 2 months? what tests will he be taking ? and what are these tests for ?
4-how do you see the doctors diagnosis? do you agree with the medications given? anything else you suggest us?
Thank you.
My sister is 24 years old, few weeks ago she was diagnosed with Rheumatoid Arthritis.
Her complain started about 4 months ago, when she developed a slight swelling in her wrists and some pain in her toes and fingers, but after sometime the pain disappeared suddenly, until few weeks ago the pain returned so we decided to go to a rheumatologist.
He did several blood tests such as
liver,kidney function tests, CBC
Vitamin d test
he also took RF factor test and anticcp test.
after the results came out, he said that all other blood test are normal except she has iron and vitamin D deficiency, the RF test was Rhematoid factor was also normal however he saw a very high Anti-ccp which was 10,835 U/ml (ten thousand +) . and it's normal level is from 0-17 U/ml,
He suggested to confirm Rheumatoid arthritis by doing more specific test which is
1-Antinuclear antibodies
2-RF factor IGG
3-RF factor IGM.
the results showed positive for Rheumatoid arthritis.
The doctor said, that currently the symptoms seems not very severe and it's good that we brought her earlier to the hospital. he gave her the following medicines for Anaemia,VitD deficiency and Rheumatoid arthritis.
1-Easy Iron Caps 30's (Twice daily)
2-Euro D 10000 IU Caps 30's (each other day)
3-Solumedrol 125mg ING (one time on the hospital day to reduce inflammation immediately)
4- Methotrexate 2.5mg Tab (4 pills one time every week).
5- Plaquenil 200mg XXXXXXX 60's (one perday)..
He said to not take methotrexate and easy iron on the same day, when taking methotrexate we should wait atleast two days and on third day take the easy iron tabs..
my questions..
1-What's the prognosis of Rheumatoid artheritis? is it fully treatable/reversible?
2-I read that methotrexate can cause infertility in male and female taking it should stop if they are planning to be pregnant ?
does it also cause infertility in female? if so is there a better alternative than methotrexate she can use?
3- The doctor said we have to go to him every 2 weeks to do other tests and then every month and then every 2 months? what tests will he be taking ? and what are these tests for ?
4-how do you see the doctors diagnosis? do you agree with the medications given? anything else you suggest us?
Thank you.
Brief Answer:
My response
Detailed Answer:
Hi,
I am Dr Mittal. I have read your message. I think I can help you.
First I would like to consider the last question. Yes I agree with the doctor. His diagnosis, treatment and method seems to be spot on.
Second, I consider your 1st query. It's treatable. but medicines have to be taken continously. It's not going to go away.
Third , methotrexate is one of the best medicines for rheumatoid arthritis. Yes other options are available. but this is the most effective medicine. Rheumatoid arthritis cam cause severe deformation that can disable a person. So I think you should consider that before talking to your rheumatology specialist regarding change to other medicines.
And lastly , yes there are other side effects of methotrexate. It can affect the liver kidney and bone marrow. So the levels have to be monitored - more frequently initially, and less so later in the course. If caught early the side effects are reversible.
I have tried to make it as simple as possible. I hope that the information contained in this message will be able to help you find the best solution for your problem. Best of luck. Dr Mittal.
My response
Detailed Answer:
Hi,
I am Dr Mittal. I have read your message. I think I can help you.
First I would like to consider the last question. Yes I agree with the doctor. His diagnosis, treatment and method seems to be spot on.
Second, I consider your 1st query. It's treatable. but medicines have to be taken continously. It's not going to go away.
Third , methotrexate is one of the best medicines for rheumatoid arthritis. Yes other options are available. but this is the most effective medicine. Rheumatoid arthritis cam cause severe deformation that can disable a person. So I think you should consider that before talking to your rheumatology specialist regarding change to other medicines.
And lastly , yes there are other side effects of methotrexate. It can affect the liver kidney and bone marrow. So the levels have to be monitored - more frequently initially, and less so later in the course. If caught early the side effects are reversible.
I have tried to make it as simple as possible. I hope that the information contained in this message will be able to help you find the best solution for your problem. Best of luck. Dr Mittal.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Doctor, for the quick response.
I have important question that i wish to hear an answer for.
I read that methotrexate can cause infertility in male and female taking it should stop if they are planning to be pregnant ?
she is not married yet, but we want to know if there is a risk for infertility for her if she takes this medicine..?
I have important question that i wish to hear an answer for.
I read that methotrexate can cause infertility in male and female taking it should stop if they are planning to be pregnant ?
she is not married yet, but we want to know if there is a risk for infertility for her if she takes this medicine..?
Brief Answer:
It's the best solution
Detailed Answer:
I already mentioned that the side effect is there but it remains the best medicine for rheumatoid arthritis. If rheumatoid arthritis progresses without check it can cause severe deformation,.
It's the best solution
Detailed Answer:
I already mentioned that the side effect is there but it remains the best medicine for rheumatoid arthritis. If rheumatoid arthritis progresses without check it can cause severe deformation,.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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