Follow-up of rheumatoid arthritis, lupus, and other autoimmune diseases through joint assessment and tests such as ANA, ENA, and rheumatoid factor.
Indication
- Morning stiffness and symmetric joint pain in the hands and wrists (suspected rheumatoid arthritis)
- Monitoring of systemic lupus erythematosus (SLE) and other connective tissue diseases
- Follow-up of spondyloarthropathies (ankylosing spondylitis, psoriatic arthritis)
- Unexplained fever, rash, joint swelling, and chronic fatigue
- Effectiveness and side-effect monitoring of biologic or disease-modifying medications in use
- Patients with joint deformity and morning stiffness lasting more than one hour
- Family history of autoimmune rheumatic disease and suspicious laboratory findings
Preparation
- An 8-hour fast before tests (for cholesterol and liver tests)
- Bringing previous results of autoimmune tests such as ANA, ENA, RF, and anti-CCP
- Stating the doses and duration of all rheumatology medications being used
- Sharing recent vaccinations and recent infection history with the physician
How it's performed
- The physician asks about joint pain, swelling, and the duration of morning stiffness
- A joint-count-based activity score (for example DAS28) is calculated
- Complete blood count, ESR, CRP, rheumatoid factor, anti-CCP, ANA, and ENA panels are requested
- Hand and foot X-rays, and if needed joint ultrasound or MRI, are used to assess structural damage
- A treatment plan (DMARDs, biologics, or small-molecule drugs) is decided together with the patient
- Hepatitis and tuberculosis screening is performed at the start of treatment
Post-procedure
- Follow-up visits every 1-3 months depending on disease activity
- Treatment response is monitored with DAS28 or similar scores
- Regular blood tests and liver/kidney monitoring according to the medications used
- Vaccination plan (influenza, pneumococcal, herpes zoster) and infection prevention measures
- Physical therapy, an exercise program, and psychological support when needed
Risks
- False-positive or false-negative results in autoimmune tests
- Risk of infection with biologic and immunosuppressive treatments
- Drug-related changes in blood counts, liver, or kidney function
- Possible progression of joint damage in active disease
- Reduced response to vaccines, with some live vaccines being contraindicated
FAQ
Does rheumatoid arthritis last a lifetime?
Rheumatoid arthritis is a chronic disease, but with early and consistent treatment disease activity can be kept low and joint damage reduced.
I have started a biologic medication; can I continue my normal life?
Most patients continue their daily activities during treatment. It is important to stay in contact with your physician about vaccination plans and signs of infection.
Does nutrition play a role in rheumatic disease?
A Mediterranean-style diet, fish rich in omega-3, and adequate vitamin D levels support overall well-being; however, diet does not replace medical treatment.
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