I.B. BAZINA¹, O.A. KOZYREV¹, YA.V. VINOKUROVA¹, D.G. KRECHIKOVA², M.V. POGODINA¹

 ¹Smolensk State Medical University, Smolensk²RZhD-Meditsina Clinical Hospital, Smolensk 

Contact details:

Bazina Irina Borisovna — PhD (Medicine), Associate Professor of the Department of Hospital TherapyAddress: 28 Krupskoy St., Smolensk, Russian Federation, 214019, tel.: +7-919-047-22-27, e-mail: billy_boss@mail.ru

 A description of the clinical case of a female patient with the onset of rheumatoid arthritis (RA) in an old age is presented. The disease began acutely against the background of comorbid pathology and was manifested by high activity, multiple involvement of large and small joints, and their swelling. A thorough examination was performed to exclude paraneoplastic syndrome. Comorbid conditions and impaired renal function did not allow the prescription of basic drugs; a good effect was obtained from methylprednisolone. Management of elderly and senile patients with RA requires an individual approach, taking into account concomitant diseases and drug tolerability.

Key words: rheumatoid arthritis, comorbidity, paraneoplastic syndrome.

REFERENCES

1. Baymukhamedov Ch. Rheumatoid arthritis in the elderly: the view of a practical rheumatologist. Nauchno-prakticheskaya revmatologiya, 2020, vol. 58, no. 4, pp. 447–450 (in Russ.).
2. Gordeev A.V., Galushko E.A., Nasonov E.L. The concept of multimorbidity in rheumatological practice. Nauchno-prakticheskaya revmatologiya, 2014, vol. 52, no. 4, pp. 362–365 (in Russ.).
3. Lila A.M., Gordeev A.V., Olyunin Yu.A., Galushko E.A. Multimorbidity in rheumatology. From a comprehensive assessment of the disease to the assessment of a complex of diseases. Sovremennaya revmatologiya, 2019, vol. 13, no. 3, pp. 4–9 (in Russ.).
4. Aletaha D., Neogi T., Silman A.J. et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology / European League Against Rheumatism collaborative initiative. Ann. Rheum. Dis., 2010, vol. 69, pp. 1580–1588.
5. Satybaldyev A.M. Rheumatoid arthritis in the elderly. Consilium Medicum, 2007, vol. 9, no. 12, pp. 85–92 (in Russ.).
6. Kats Ya.A. Debut of rheumatoid arthritis in old age. Meditsinskie nauki, 2012, no. 5, pp. 36–43 (in Russ.).
7. Mastbergen S.C., Jansen N.W., Bijlsma J.W., Lafeber F. Differential direct effects of cyclooxygenase-1/2 inhibition on proteoglycan turnover of human osteoarthritic cartilage: an in vitro study. Arthritis Res Ther, 2006, vol. 8 (1), r. 2.
8. Kobak S., Bes C. An autumn tale: geriatric rheumatoid arthritis. Ther. Adv. Musculoskelet. Dis, 2018, vol. 10 (1), pp. 3–11.
9. Kozhevnikova P.O., Dydykina I.S., Lila A.M. Features of the course of rheumatoid arthritis in older people. Klinicheskaya gerontologiya, 2020, no. 11–12, pp. 46–52 (in Russ.).
10. Raskina T.A., Malyshenko O.S., Pankratova S.Yu., Fanaskov V.B., Letaeva M.V. Rheumatoid arthritis in elderly patients. Sovremennaya revmatologiya, 2017, vol. 11, no. 1, pp. 33–37 (in Russ.).