Abstract

ASSOCIATION OF PLATELET INDICES WITH DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS

Author(s): Ricky Mathew, Satish Kumar

BACKGROUND Rheumatoid arthritis is a chronic systemic inflammatory disease of uncertain aetiology that primarily affects synovium and also involves numerous extra-articular tissues. The amount of clinical disease activity indicates the level of inflammation and is the basis of treatment decisions. Treatment guidelines recommend starting with DMARD monotherapy. The goal of therapy is disease remission or very low disease activity. Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) are the commonly used markers of inflammation. Platelet have been shown to play an important role in inflammation by several mechanisms. Platelet indices have been studied in various inflammatory conditions including systemic lupus erythematosus, familial Mediterranean fever and inflammatory bowel disease. MATERIALS AND METHODS In the present study, normative survey cum longitudinal experimental observation technique were used. The equivalent two group design were selected for observation. Duration of the study was 10 months. The sample comprised of 30 patients aged 30-60 years each in a group. The sample was selected on the basis of inclusion and exclusion criteria. The tools such as clinical profile and 2010 ACR-EULAR classification criteria checklist were used. Initially, the general profile, checklist (ACR-EULAR) for joint involvement, serology, acute phase reactant and duration of symptoms were given. Assessment of current disease activity is important in treatment discussions in rheumatoid arthritis. Currently, ESR and CRP are the commonly used markers of inflammatory activity. RESULTS Platelet indices show variation with disease activity. In this study, there was an increase in platelet count and plateletcrit with disease activity, while MPV showed a decrease with active disease. There was also a significant correlation between the parameters and DAS 28 score. CONCLUSION Platelets have a significant role in the pathogenesis and progression of inflammatory disease including rheumatoid arthritis. Platelet indices maybe a cheaper and more easily available alternatives to ESR and CRP in assessing disease activity in patients with RA and this may help in guiding therapeutic strategies.