Role of biochemical markers in rheumatoid arthritis

Abstract

Rheumatoid arthritis is the most common chronic, progressive systemic inflammatory arthritis of unknown cause. It affects approximately 1-2% of the population worldwide. It is a form of autoimmune disease principally synovial tissues. As the pathophysiology involves affecting cell mediated immune response, adenosine deaminase may have a role in rheumatoid arthritis. As it involves bones and joints, it is likely that it alters the levels of Serum Calcium, Phosphorus and Magnesium as well as Alkaline Phosphatase which may be helpful in diagnosis or management of the disease. 1. To evaluate the role of serum adenosine deaminase (ADA) as a marker of cell mediated immunity in Rheumatoid Arthritis. 2. To estimate serum alkaline phosphatase, calcium, phosphorus and magnesium as prognostic markers of Rheumatoid arthritisA cross-sectional, case control study with convenient sampling was undertaken after Institutional Ethical Clearance & informed consent. 30 patients of Rheumatoid Arthritis presenting to the orthopaedic outpatient department of Owaisi Hospital and Research Centre, Hyderabad were taken as cases along with an equal number of age and sex matched controls from January 2021 to June 2021. ADA levels were estimated by colorimetric assay on ErbaChem 7 semiautoanalyser. Serum Alkaline phosphatase, Calcium, Phosphorus and Magnesium were estimated on Cobas C311 autoanalyzer. There was a significant increase in levels of Adenosine Deaminase, Alkaline Phosphatase and Serum Phosphorus, while the levels of Calcium and Magnesium were significantly reduced in rheumatoid arthritisADA as a marker of cell mediated immunity reflects monocyte / macrophage activity and was increased in our study suggesting immunological and inflammatory process in the pathogenesis of Rheumatoid Arthritis (R.A). It can be used as a non invasive marker of chronic inflammation and may provide additional information about disease prognosis.Increased levels of Alkaline Phosphatase and Phosphorus associated with low Calcium and Magnesium suggest increased bone resorption in R. A and are useful as markers of disease activity.