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.
