Extra-articular manifestations in rheumatoid arthritis and its relationship with serology markers in Saudi patients

Introduction: Extra-articular manifestations of Rheumatoid arthritis (ExRA) are defined as all the diseases and symptoms which are not directly linked to the musculoskeletal system and can occur at any age after onset. The study aimed to investigate the frequency of ExRA patients and to assess its relationship to serology markers. Methods: This observational cross-sectional study was carried out on 60 Saudi patients with newly or previously diagnosed RA according to 2010 American College of Rheumatology-European League against Rheumatism criteria. They were followed in the Rheumatology Clinic at King Khalid Majmaah Hospital (KKMH) from January 2017 to December 2020. Data collected was analyzed by SPSS 26 and appropriate statistical tests were applied. Results: A total of sixty patients (52 women; 8 men) who visited KKMH were included in this study. The mean age of the patients was 47.87 +/- 11.55 years, and the female-to-male ratio was 6.5:1. Out of the total, 14 patients (23.3%) had a family history of RA. 18 patients developed ExRA features; anemia occurred in 30%, Sjogren's syndrome in 8.3%, thrombocytosis in 6.7%, and leukopenia in 3.3%. Further, 40 patients (66.7%) were positive for RF, 47 (78.3%) for anti-CCP antibodies, and both markers were positive in 36 (60%) of the patients. Among 18 patients with ExRA, the percentage of positive RF and anti-CCP were 25% and 32%, respectively, while 42 patients with no ExRA, both markers were positive in 75 % and 68 %, respectively. Conclusion: Anemia is the most common extra-articular manifestation of TA, however, no significant relationship was observed between serology markers and extra-articular manifestations of RA.