It is largely believed that arthritis is a disease of the aged. However, this is a misconception! Most arthritis are autoimmune diseases which means that our body recognizes ourself as “foreign” and hence attacks “self”. Autoimmune diseases are more common in women than men and can affect all age groups including children. Some examples of autoimmune arthritis include rheumatoid arthritis, psoriatic arthritis, lupus, vasculitis, scleroderma etc.Off-late improved awareness of various arthritis amongst the general public, widely available specific blood tests, rheumatologist involvement at an early stage, widely available educational material online are some of the reasons for early diagnosis.
A genetic predisposition is needed for arthritis to occur. In a genetically predisposed individual, an environmental insult such as viral infection, environmental pollution amongst others may enhance earlier onset of the illness. Smoking and poor dental hygiene may hasten the development of rheumatoid arthritis. Likewise bright sunlight exposure can worsen skin rash of lupus. Hormonal medications containing high estrogens can increase the risk of flare of a disease like lupus and increase risk of clot formation in these patients.
The presence of certain abnormalities in our genes is a pre-requisite for some types of arthritis. HLA-B27 is one such gene when present increases the risk of development of certain type of arthritis such as psoriatic arthritis and ankylosing spondylitis. A genetic defect has recently been found to be the cause of another autoimmune disease – Vasculitis.
Arthritis: Early signs to know
However, one particular type of arthritis that was once traditionally occurring more in middle to later age men but now is being increasingly recognized in the younger adults is Gout. This is predominantly due to modernization of our lifestyle. Obesity, excess binge consumption of alcohol, aerated drinks and canned fruit juices, excess consumption of red meat or sea food have led to increased blood levels of a particular salt called Uric acid. Very high blood levels of uric acid is known to get deposited in the joints causing a severe arthritis called Gout and in the kidney as uric acid stones. Very high levels of uric acid are also known to increase the risk of early development of hypertension, heart and kidney disease. Hence life-style changes with weight loss, regular exercise, mindful eating and reducing consumption of alcohol and aerated drinks can be very useful.
Even though there are no specific life style measures to prevent the development of various arthritis, since majority of them are due to altered immune system in the body, the severity can be reduced by quitting smoking and a healthy life style. Early diagnosis and early initiation of effective treatment can lead to better quality of life by preventing joint damage and preserving organ function. In order to achieve this early referral to a rheumatologist (arthritis specialist) is the key.
(Author: Dr. Ramesh Jois, Consultant- Rheumatology, Manipal Hospital Millers Road)
