Pattern of rheumatoid arthritis in Nigeria; Study of patients from a Teaching Hospital

Abstract

Introduction: Rheumatoid Arthritis (RA) is an autoimmune inflammatory polyarthritis with numerous extraarticular manifestations. It is said to be rare among black Africans, however there has been a report from a private clinic in Nigeria. We hereby present the clinical and laboratory patterns of presentation of rheumatoid arthritis in a tertiary hospital in Nigeria.
Methods: This was a four year retrospective study of patients that presented to the Rheumatology unit of Lagos State University Teaching Hospital (LASUTH). The diagnosis was based on either the American College of Rheumatology (ACR) criteria or the ACR/ European League of Associations Against Rheumatism (EULAR) 2010 classification criteria for RA.
Results: A total of one thousand two hundred and fifteen patients with rheumatological disorders were seen at the rheumatology unit of LASUTH during the four year period. Of these, 128 (10.6%) patients fulfilled classification criteria for RA. Female to male ratio was 6.1:1. Mean age of the patients was 41.4 years.The proximal interphalangeal joint was mostly affected. ESR and CRP were mostly elevated. Test for Rheumatoid Factor (RF) was positive in 78 (72.2%). Anti-CCP was positive in 54 (61.1%). Radiographs of the hands predominantly showed erosions and periarticular osteopenia. Treatment was with Disease – Modifying Anti-Rheumatic Drugs (DMARDs) and prednisolone.
Conclusion: Rheumatoid arthritis could be a significant medical condition among Nigerians. Nigerians who suffer RA have predominantly high titres of RF and anti- CCP. ESR and to a less extent CRP are usually elevated.

Key words: Rheumatoid arthritis, Clinical and laboratory parameters, Treatment, Nigerians