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19 Adar 5761 - March 14, 2001 | Mordecai Plaut, director Published Weekly
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Home and Family
Your Medical Questions Answered!

by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital

Last week we discussed osteoarthritis which seems to be truly a disease of aging. This is the only one of the arthritises that is not considered a rheumatoid problem.

Rheumatoid problems are the realm of rheumatologists -- and these diseases for the most part involve the joints, for the most part are chronic and not lethal, and for the most part are uncommon. They all share a unique mechanism. We don't know how they get started but they all involve the body attacking its own cells. That is, the body suddenly considers some of its cells to be foreign and attacks them. This is called auto-immunity.

The diseases in this group include the following -- rheumatoid arthritis, sarcoidosis, lupus, Sjorgen's syndrome, Behcet's syndrome, and Reiter's syndrome. A related disease in children that may also affect them in adulthood is JRA, or juvenile rheumatoid arthritis. Also included here are two diseases that are auto-immune diseases, and cause joint problems despite not being thought of as such. One is the skin disease psoriasis and the other is inflammatory bowel disease, which is the two diseases ulcerative colitis and Crohn's disease, both very common in Jews. Finally, diseases that we do know the cause of, include gout and pseudogout, which are diseases where the body dumps by-products of metabolism in the joints that are then attacked by the body.

Because most of these diseases are unusual, I won't go into detail on most of them, unless one of my readers specifically requests me to. I'll just say that lupus and sarcoidosis are more common in females, and Reiter's is more of a male disease. Reiter's is more common in people with a certain chromosome, and a simple blood test will help diagnose this. All these diseases can be controlled, and most sufferers have normal lives, although all can sometimes go bad (I'm not sure I would give up a shidduch because of one of these diseases). We will go into more detail on gout, rheumatoid arthritis, psoriasis and the two bowel diseases, because they are much more common. Finally, we briefly mention the problems of transplants, because rejection of transplants often goes by the same mechanism and is often treated with the same medicine. Write me in care of the Yated.

A message from Glaxo, sponsor of this column. Relenza is an antiviral which works well against the flu if started early. If you can afford to be sick, and who can, consider this if the flu strikes this season.

 

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