Anemia Of Chronic Disease
One type called anemia of chronic disease, or ACD is a major cause of anemia in people with RA. In one study of 225 RA patients, ACD accounted for 77 percent of the observed anemia. Its also the most common form of anemia in lupus patients.
Also called anemia of inflammation, ACD affects people who have conditions that cause inflammation, such as infections, cancer, chronic kidney disease, and autoimmune diseases .
With ACD, you may have normal or sometimes increased amounts of iron stores in your body tissue, but a low level of iron in your blood. Chronic inflammation may prevent your body from using the stored iron to create new red blood cells, which leads to anemia. Inflammation can also affect the way your body produces a specific hormone called erythropoietin, which controls the production of red blood cells. A 2008 study of 111 patients with early RA reported the prevalence of ACD to be 25 percent during the first year of disease.
Getting inflammation under control with medication is the best way to treat this kind of anemia.
Psoriatic Arthritis Blood Test: C
C-reactive protein is a protein in the blood that indicates inflammation. If a blood test shows high CRP levels, you might have psoriatic arthritis, explains Dr. Husni.
Your doctor may use the test if your ESR is normal, since CRP is more accurate at detecting inflammation in some people, adds Cadet.
Again, different labs may have slightly different interpretations of readings.
Frequency of Testing CRP analysis may be done for diagnosis and then several times a year to assess whether inflammation has responded to treatment, notes Cadet.
You Might Avoid Wearing Short Sleeves On A Hot Day If You Have Psoriasis Too
As if psoriatic arthritis wasnt enough, many people with the condition also have psoriasis, which produces patches of thick, red skin and silvery scales. Even when the temperature is 80 degrees and climbing, sleeveless shirts arent an option for many. My psoriasis is mainly on my elbows, so I would never dream of wearing a sleeveless dress, Dishner says. Three-quarter sleeves are my best friends.
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Have Your Vitamin D Tested
There has been plenty of research that shows a connection between vitamin D deficiency and psoriatic arthritis. For example, one 2015 study reported in Arthritis Research & Therapy finds up to 40.9% of the PsA study participants also had vitamin D deficiency, this compared to only 26.9% of the control participants.
Chronic fatigue is one of the most common symptoms of vitamin D deficiency. If you think you have a deficiency, talk to your healthcare provider about getting your blood levels tested. Vitamin D deficiency is easily treated by eating more vitamin D rich foods, and with vitamin D supplements.
Psoriatic Arthritis Blood Test: Hla
HLA-B27 is a blood test that looks for a genetic marker for psoriatic arthritis a protein called human leukocyte antigen B27 , which is located on the surface of white blood cells. About 20 percent of people with psoriatic arthritis are positive for HBL-B27, according to CreakyJoints.
HLA-B27 is associated with a larger group of autoimmune diseases, called spondyloarthropathies, which includes psoriatic arthritis, Cadet says. These conditions can cause inflammation in the enthesis anywhere in the body but mainly in the spine.
If untreated over a long period, this inflammation may cause the destruction of cartilage, muscle spasms, and a decrease in bone mineral density that may lead to osteopenia or osteoporosis.
Frequency of Testing The HLA-B27 test is usually performed only at an initial visit to help establish a diagnosis, says Cadet.
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What Is A Common Side Effect Of Psoriatic Arthritis
ANSWER
Extreme fatigue is a common side effect of psoriatic arthritis. Its also a side effect of many meds that treat it. Your condition may also cause anemia, which leads to fatigue.
If you feel more tired than usual, tell your doctor so they can find out whats causing it and how to fix it.
National Psoriasis Foundation.
Philip Mease, MD, Seattle Rheumatology Associates.
John Hardin, MD, chief scientific officer, Arthritis Foundation professor of medicine, Albert Einstein College of Medicine, New York City.
Arthritis Foundation.
Johns Hopkins Arthritis Center.
Tilling, L. Clinical Drug Investigation, 2006.
News release, FDA.
National Psoriasis Foundation.
Philip Mease, MD, Seattle Rheumatology Associates.
John Hardin, MD, chief scientific officer, Arthritis Foundation professor of medicine, Albert Einstein College of Medicine, New York City.
Arthritis Foundation.
Johns Hopkins Arthritis Center.
Tilling, L. Clinical Drug Investigation, 2006.
News release, FDA.
This tool does not provide medical advice. See additional information.
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As Can The Words Youre Too Young To Have Arthritis
When you say the word arthritis, every older person you meet has it, too, Dishner says. While well-meaning people may sympathize by comparing their own ailment with yours, psoriatic arthritis is a much different form of arthritis and does not develop because of aging. It can occur at any age but typically begins to cause symptoms among those between 30 and 50 years old, according to the NPF.
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How Other Medications Affect Anemia In Arthritis
Aside from NSAIDs, other medications may lead to forms of anemia as well.
Some disease-modifying anti-rheumatic drugs like methotrexate , sulfasalazine , and leflunomide used to treat RA have been associated with aplastic anemia. This rare, but serious, form of anemia occurs when theres damage to your bone marrow and your body stops producing enough new blood cells. Loss of bone marrow caused by certain drugs used to treat lupus can also reduce red blood cell production, according to the Lupus Foundation of America.
Different types of anemia are treated in different ways. Your doctor will need to determine the cause of your anemia in order to figure out next steps.
Clinical Signs And Symptoms
- Non-steroidal Anti-Inflammatory Drugs
- Local Corticosteroid Injections
NOTE: Neither NSAIDS or intra articular corticosteroids will stop structural joint damage
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Who Is At Risk For Psoriatic Arthritis
Psoriasis affects 2-3 percent of the population or approximately 7 million people in the U.S. and up to 30% of these people can develop psoriatic arthritis. Psoriatic arthritis occurs most commonly in adults between the ages of 35 and 55 however, it can develop at any age. Psoriatic arthritis affects men and women equally.
It is possible to develop psoriatic arthritis with only a family history of psoriasis and while less common, psoriatic arthritis can occur before psoriasis appears. Children of parents with psoriasis are three times more likely to have psoriasis and are at greater risk for developing psoriatic arthritis. The most typical age of juvenile onset is 9-11 years of age.
Psoriatic Arthritis Imaging Test: Mri
If the X-rays dont show inflammation, and the doctor wants more evidence, they may do an MRI, Rubenstein says. Thats because MRIs are more precise than X-rays. This noninvasive imaging technique uses a magnetic field and computer-generated radio waves to create detailed three-dimensional images.
During an MRI, you lie inside a machine and remain very still while the device moves a strong magnetic field, then radio waves, through your body to excite protons found in the water that makes up human tissue, according to the National Institute of Biomedical Imaging and Bioengineering. The procedure is painless and, unlike X-ray imaging, does not emit radiation.
A radiologist analyzes the MRI, then reports back to the rheumatologist. Inflammation, swelling, and bone erosion all indicate that psoriatic arthritis is active, notes Rubenstein.
Frequency of Testing A doctor may order an MRI during initial testing to help with making a psoriatic arthritis diagnosis, as well as later to monitor the disease or look for any changes in a patients psoriatic arthritis symptoms. Tests may be done several times a year, says Cadet.
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Risk Factors For Pernicious Anemia
Some people have a higher risk for pernicious anemia. This includes those with a family history of the condition and people of Northern European or Scandinavian backgrounds.
Verywell / Laura Porter
Additional risk factors associated with PA include:
- Being female, as in one study, 81% of participants with PA were female
- Having another autoimmune condition like PsA or type 1 diabetes
- Having had part of your stomach removed
- Being older than age 60
- Having an intestinal condition that prevents the body from absorbing vitamin B12, such as Crohns disease
- Taking medicines that prevent the body from absorbing vitamin B12, including antibiotics and medications to treat diabetes or seizures
- Being a strict vegetarian or vegan who doesnt eat animal products, including dairy, and who doesnt take B12 supplements, as well as someone who doesnt eat a healthy and balanced diet
- Having a tapeworm infection, as tapeworms feed off of vitamin B12 in the small intestine tapeworm infections are caused by ingesting food or water contaminated with tapeworm eggs or larvae.
The autoimmune process that causes PA cannot be prevented. Vitamin B12 deficiency linked to other conditions is preventable to the extent those conditions also can be prevented. If vitamin B12 deficiency is related to diet, PA can be prevented with oral B12 supplements.
Psoriatic Arthritis Imaging Test: Bone Mineral Density
The most common bone mineral density test is called DXA , for dual-energy X-ray absorptiometry. This test uses X-rays to measure how many grams of calcium and other bone minerals are packed into a segment of bone. The denser the bones, the stronger and healthier they are.
Unfortunately, common psoriatic arthritis medications such as prednisone, a corticosteroid can weaken bones over time and increase the risk of osteoporosis. And psoriatic arthritis itself is associated with a decrease in bone mineral density, notes Rubenstein.
If youre diagnosed with osteopenia, a condition involving weakened bones that may lead to osteoporosis, your doctor will discuss medications that can slow or stop bone loss, and may recommend calcium and vitamin D supplements along with resistance exercise, says Rubenstein.
Frequency of Testing Bone density screening is done during menopause and every one to two years after that, says Rubenstein. If a patient is on prednisone or other medications that decrease bone mineral density, the test may be done earlier and repeated every one to two years.
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Psoriatic Arthritis Blood Test: Anemia
When you have psoriatic arthritis, ongoing inflammation may cause anemia, a decrease in healthy red blood cells that can lead to dizziness, shortness of breath, and exhaustion, says Cadet.
By measuring your blood levels of hemoglobin , your doctor can determine if you have anemia. A normal reading for women is 12 to 16 grams of hemoglobin per deciliter of blood 14 to 18 grams is normal for men, according to the Mayo Clinic.
If blood work reveals anemia, your doctor will give you an exam and other blood tests to find the cause. In people with psoriatic arthritis, treatments that reduce inflammation also help with anemia, explains Cadet.
Frequency of Testing Doctors may order tests to be done several times a year to see if the anemia has worsened or improved.
Additional reporting by .
Neither Will Taking Deep Breaths Or Meditating
While your well-meaning yogi friend may think the cure for your symptoms is to practice a few asanas, try as you might, yoga is not a cure for psoriatic arthritis. However, it may alleviate stress, and stress can worsen symptoms and bring on a flare. Yoga can also help ease pain and increase mobility, according to the National Psoriasis Foundation . So if you find the practice relaxing and beneficial, go for it!
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Diagnostic Tests/lab Tests/lab Values
- There is no definitive test. Diagnosis is made by ruling out other conditions.
- X-rays are the current gold standard. However, signs of psoriatic arthritis often do not appear on radiographs until later stages of the disease when bone erosion has occured.
- Contrast enhanced ultra sound is starting to play a leading role since it can detect changes in bone and soft tissue much sooner than X-rays.
- Early studies have demonstrated that ultrasound and MRI are both highly sensitive to early inflammatory joint changes that occur in psoriatic arthritis.
- DIP erosive changes on X-rays may support the diagnosis.
- Blood work will be done to detect for the HLA-B27 since it is a common histocompatibility complex marker in people with psoriatic arthritis.
- A blood test for rheumatoid factor should be done to rule out rheumatoid arthritis.
- A blood test for antinuclear antibody should be done to rule out Lupus.
- CBC should be done to check for a reduction in red blood cells that sometimes occurs in psoriatic arthritis.
- A joint aspiration may be done in which a syringe removes fluid from a joint. The fluid is then examined for the presence of infection, crystals, and white blood cells.
Moderate To Severe Disease
- Disease-Modifying antirheumatic drugs also called Slow-Acting Antirheumatic Drugs-these drugs will suppress the disease activity www.webmd.com/rheumatoid-arthritis/modifying-medications
- Anti-tumor necrosis factor: should be used if patients do not respond well to NSAIDS or DMARDS. These can include adalimumab, etanercept, golimumab and infliximabwww.drugs.com/mtm/infliximab.html,www.drugs.com/cdi/etanercept.html,www.drugs.com/cdi/alefacept.html These drugs which are given intravenously reduce T-cells so that less tumor necrosis factor is released. Both are highly effective but do come with risks since they weaken the immune system.www.psoriasisguide.ca/medical_treatment/immunobiologics/biologic_drugs.html
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Youre A Serious Germaphobe
You wash your hands religiously, carry sanitizing wipes everywhere, and avoid germ hubs, such as bowling alleys and movie theaters. And with good reason: Anything that can affect your immune system may worsen your symptoms. Many psoriatic arthritis medications suppress the immune system, leaving you more susceptible to germs, and flare-ups can occur when you get an infection. While vitamins and general attention to hygiene can help ward off sickness, having to skip bowling night with your family to avoid getting sick can still sting even if it does help you avoid a monthlong cold.
What Is Psoriatic Arthritis
Psoriatic arthritis is a type of arthritis linked with psoriasis, a chronic skin andnail disease. Psoriasis causes red, scaly rashes and thick, pitted fingernails.Psoriatic arthritis is similar to rheumatoid arthritis in symptoms and jointswelling . But it tends to affect fewer joints than RA. And it does notmake the typical RA antibodies. The arthritis of psoriatic arthritis comes in 5forms:
- Arthritis that affects the small joints in the fingers, toes, or both
- Asymmetrical arthritis of the joints in the hands and feet
- Symmetrical polyarthritis, which is similar to RA
- Arthritis mutilans, a rare type of arthritis that destroys and deforms joints
- Psoriatic spondylitis, arthritis of the lower back and the spine
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What Are The Treatment Options For Psoriatic Arthritis
The aim of treatment for psoriatic arthritis is to control the disease and relieve symptoms. Treatment may include any combination of the following:
- Splinting.
- Surgery.
Choice of medications depends on disease severity, number of joints involved, and associated skin symptoms. During the early stages of the disease, mild inflammation may respond to nonsteroidal anti-inflammatory drugs . Cortisone injections may be used to treat ongoing inflammation in a single joint. Oral steroids, if used to treat a psoriatic arthritis flare, can temporarily worsen psoriasis. Long-term use of oral steroids should be avoided when possible due to the negative effects on the body over time.
DMARDs are used when NSAIDs fail to work and for patients with persistent and/or erosive disease. DMARDs that are effective in treating psoriatic arthritis include: methotrexate, sulfasalazine, and cyclosporine.
Biologic agents are an important consideration when disease control is not being achieved with NSAIDS or DMARDs. Biologics have been utilized for the treatment of psoriatic arthritis since 2005 and are highly effective at slowing and preventing progression of joint damage. Your healthcare provider will complete additional laboratory tests and review safety considerations before initiating a medication regimen. Gaining good control of psoriatic arthritis and psoriasis is important to avoid increased systemic risks, particularly heart disease.
Exercise
Heat and cold therapy
Splinting
Surgery
Managing Psoriatic Arthritis Fatigue
The first step in managing fatigue is identifying the possible causes. Youll need to work with your health care provider to figure out why youre feeling so wiped out.
Depending on your overall health and underlying medical conditions, treatment suggestions may include the following:
- Lifestyle changes
- Medication adjustments
- Therapy and mental/emotional help through support groups
- Supplements
Its not a quick conversation. There are a lot of things that can be causing fatigue, says Dr. Bartlett. But its much easier to do something about your fatigue, once you dig down and identify the root cause.
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