INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCHERS
ISSN: 3030-332X Impact factor: 8,293
Volume 10, issue 1, February 2025
https://wordlyknowledge.uz/index.php/IJSR
worldly knowledge
Index:
google scholar, research gate, research bib, zenodo, open aire.
https://scholar.google.com/scholar?hl=ru&as_sdt=0%2C5&q=wosjournals.com&btnG
https://www.researchgate.net/profile/Worldly-Knowledge
https://journalseeker.researchbib.com/view/issn/3030-332X
92
Kutlikova G.M., Abdurakhmonov I.T.,
Otakhonova N.S., Aripova N.K.
KUAF Kokand University, Andijon Branch
PERIPHERAL RED BLOOD VALUES IN PATIENTS WITH RHEUMATOID ARTHRITIS
Abstract:
Rheumatoid arthritis (RA) is a chronic inflammatory disease that can have a
significant impact on peripheral blood parameters. Changes in blood tests in patients with RA
reflect both inflammatory processes and the consequences of autoimmune activity, and can also
be associated with the use of various therapeutic agents.
Keywords:
Rheumatoid arthritis, Peripheral blood, Leukocytosis, Anemia, Thrombocytosis, ESR
(erythrocyte sedimentation rate), C-reactive protein (CRP), Rheumatoid factor (RF),
Anticitrullinated antibodies (ACPA), Hemoglobin, Hematocrit
.
Introduction.
Rheumatoid arthritis (RA) is one of the most common chronic inflammatory joint
diseases characterized by an autoimmune process that leads to progressive damage to the joints
and other organs. Along with clinical manifestations, RA is accompanied by significant changes
in the peripheral blood, which reflect both the degree of inflammatory activity and possible
complications caused by the disease itself or its treatment. The study of peripheral blood
parameters in patients with RA is important not only for diagnosis and monitoring of the disease,
but also for assessing the effectiveness of therapy. Common changes in the blood include
leukocytosis, anemia, thrombocytosis, and increased levels of inflammatory markers such as
ESR (erythrocyte sedimentation rate) and C-reactive protein (CRP). These indicators help the
doctor determine the stage of the disease, assess its activity and the adequacy of therapy.
Some of the key biomarkers of RA are rheumatoid factor (RF) and anticitrulline antibodies
(ACPA), which serve as specific indicators of the disease. Increased values of these
antibodies may indicate disease progression and complications. Abnormalities in hematopoiesis,
such as anemia, are a common consequence of chronic inflammation, impaired iron metabolism
and the effects of drugs. Thus, the study of peripheral blood parameters in patients with RA is an
important tool for monitoring the condition of patients, allows timely detection of complications
and assessment of the dynamics of the disease. Introduction to the topic of blood changes in RA
is the basis for further study of the role of these parameters in clinical practice and their
relationship with various aspects of the disease. Materials and methods of study. To study
peripheral blood parameters in patients with rheumatoid arthritis (RA), a retrospective analytical
evaluation of clinical data of patients observed in specialized rheumatology centers was carried
out. The study included patients diagnosed with RA who received outpatient or inpatient
treatment, as well as patients with diagnosed acute exacerbations of the disease.
1. Study materials. The study material was peripheral blood of patients with rheumatoid arthritis,
taken at different stages of the disease and at different points in treatment. The study included the
following groups:
Group 1: patients with active RA (exacerbation of the disease, high inflammatory activity);
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCHERS
ISSN: 3030-332X Impact factor: 8,293
Volume 10, issue 1, February 2025
https://wordlyknowledge.uz/index.php/IJSR
worldly knowledge
Index:
google scholar, research gate, research bib, zenodo, open aire.
https://scholar.google.com/scholar?hl=ru&as_sdt=0%2C5&q=wosjournals.com&btnG
https://www.researchgate.net/profile/Worldly-Knowledge
https://journalseeker.researchbib.com/view/issn/3030-332X
93
Group 2: patients with RA remission (decrease in disease activity, stabilization of
symptoms);
Group 3: control group consisting of healthy donors.
2. Study methods
2.1. Complete blood count
Complete blood count was performed using automated analyzers (e.g., Coulter, Sysmex, or
similar) to accurately measure the following parameters:
White blood cell count and differential (neutrophils, lymphocytes, monocytes, eosinophils,
basophils);
Hemoglobin level;
Hematocrit (percentage of cellular elements to plasma);
Platelet count;
Mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration
(MCHC).
2.2. Determination of C-reactive protein (CRP). To assess inflammatory activity, the C-
reactive protein (CRP) level was measured. This indicator was determined using the
immunoturbidimetric method or using automated analyzers such as Cobas (Roche) or
similar. An increase in CRP levels serves as a marker of an active inflammatory process.
2.3. Erythrocyte sedimentation rate (ESR).
ESR was measured using the Panchenkov method or using automatic analyzers (for
example, in blood biochemistry analysis equipment systems). This is an indicator that is
actively used to monitor inflammation activity in RA.
2.4. Determination of rheumatoid factor (RF) and anticitrulline antibodies (ACPA)
Rheumatoid factor was determined by latex particle agglutination, as well as using more specific
methods such as enzyme-linked immunosorbent assay (ELISA) or chemiluminescent
immunoassay (CLIA).
Anti-citrulline antibodies (ACPA) were detected using highly sensitive ELISA methods or other
serological tests.
2.5. Statistical data processing
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCHERS
ISSN: 3030-332X Impact factor: 8,293
Volume 10, issue 1, February 2025
https://wordlyknowledge.uz/index.php/IJSR
worldly knowledge
Index:
google scholar, research gate, research bib, zenodo, open aire.
https://scholar.google.com/scholar?hl=ru&as_sdt=0%2C5&q=wosjournals.com&btnG
https://www.researchgate.net/profile/Worldly-Knowledge
https://journalseeker.researchbib.com/view/issn/3030-332X
94
SPSS or Statistica software was used for statistical data processing. The results are presented as
mean (M) and standard deviation (SD). For comparison between groups, the t-test or ANOVA
was used depending on the number of groups and their normal distribution. For correlation
between indicators, the Pearson correlation coefficient was used.
3. Ethical aspects.
The study was conducted in accordance with the principles of medical ethics approved by WHO,
taking into account the confidentiality of patient data. All patients signed an informed consent to
participate in the study. Peripheral blood in patients with rheumatoid arthritis (RA) may show a
number of changes that are related to both the disease itself and treatment. It is important to
understand that RA is a chronic inflammatory disease that can affect various organs and systems,
including the circulatory system.
Key blood parameters in patients with RA:
1.
1. Leukocytes (leukocytosis):
o
o Usually, there is an increase in the number of leukocytes in the peripheral blood,
which is associated with inflammation. Leukocytosis (usually neutrophilic) is an
indicator of the activity of the inflammatory process.
o
o In some cases, with a long course of the disease, there may be neutropenia (a
decrease in the number of neutrophils).
o
2. Hemoglobin:
o
o Most patients with RA have anemia, which is explained by chronic
inflammation. Anemia may be anemia of chronic disease, in which there is a
decrease in hemoglobin and hematocrit. This condition is associated with a
disruption of normal iron metabolism and its absorption.
o
o Iron deficiency is also possible, especially with long-term disease and / or
the presence of ulcers in the gastrointestinal tract.
o
3. Platelets:
o
o There may be an increased number of platelets in the peripheral blood
(thrombocytosis), which is another indicator of inflammation.
o
o In some cases, thrombocytopenia may develop, which is associated with the
peculiarities of the course of the disease or side effects of drugs.
o
4. ESR (erythrocyte sedimentation rate):
o
o ESR is one of the most sensitive indicators of inflammation, and in patients
with RA with active inflammation, this indicator is often significantly
elevated.
o
o ESR can be used to assess disease activity, as high values usually
correlate with the intensity of the inflammatory process.
o
5. C-reactive protein (CRP):
o
o This is an important indicator of inflammatory activity, which is often
elevated in patients with RA. CRP is a marker of acute inflammation, and its
level can be used to monitor the effectiveness of therapy and disease activity.
o
6. Rheumatoid factor (RF):
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCHERS
ISSN: 3030-332X Impact factor: 8,293
Volume 10, issue 1, February 2025
https://wordlyknowledge.uz/index.php/IJSR
worldly knowledge
Index:
google scholar, research gate, research bib, zenodo, open aire.
https://scholar.google.com/scholar?hl=ru&as_sdt=0%2C5&q=wosjournals.com&btnG
https://www.researchgate.net/profile/Worldly-Knowledge
https://journalseeker.researchbib.com/view/issn/3030-332X
95
o
o Rheumatoid factor is an autoantidiv that is often present in patients with
RA. Although its presence is not always associated with the severity of the
disease, its high concentration may indicate a more active form of RA.
o
o About 70-80% of patients with RA are positive for rheumatoid factor, but
it can be elevated in other diseases.
o
7. Anticitrullinated antibodies (ACPA):
o
o These antibodies are also specific for RA and can be used in the diagnosis
of the disease, especially in the early stages, when rheumatoid factor may be
negative.
o
o A positive result for anticitrullinated antibodies usually indicates a more
aggressive course of the disease.
o
8. Red blood cells:
o
o Normocytic normochromic anemia may be observed in the peripheral
blood, which often occurs in patients with inflammatory diseases, including
RA.
o
o A slight decrease in the number of red blood cells may also be observed in
some cases.
Effect of treatment on blood parameters:
• The use of nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, or disease-
modifying antirheumatic drugs (DMARDs) may change the blood picture, for example:
o Glucocorticoids may cause leukopenia and thrombocytosis.
o Methotrexate, which is often used in RA, may cause leukopenia, anemia, and changes
in platelet counts.
o Biological drugs (eg, tumor necrosis factor inhibitors) may also affect blood
composition, causing neutropenia or other changes.
Thus, peripheral blood parameters in patients with RA may vary depending on the
disease activity, comorbidities, and the therapy being administered. Regular monitoring of these
parameters helps to assess both the patient's condition and the effectiveness of the treatment.
Conclusion.
Changes in peripheral blood parameters in patients with rheumatoid arthritis (RA) play an
important role in assessing disease activity, as well as in monitoring the effectiveness of
treatment. Increased levels of inflammatory markers, such as ESR and C-reactive protein,
leukocytosis, anemia and thrombocytosis, are characteristic signs of the inflammatory process
and chronic inflammation accompanying RA. These changes can serve as indicators of both the
current activity of the disease and potential complications associated with its course. Particular
attention should be paid to biomarkers such as rheumatoid factor and anticitrulline antibodies,
which are specific for RA and can help in the early diagnosis of the disease, as well as in
predicting its progression. Hematopoiesis disorders, such as anemia, often develop against the
background of chronic inflammation, iron deficiency or side effects of treatment, which also
requires constant monitoring.
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCHERS
ISSN: 3030-332X Impact factor: 8,293
Volume 10, issue 1, February 2025
https://wordlyknowledge.uz/index.php/IJSR
worldly knowledge
Index:
google scholar, research gate, research bib, zenodo, open aire.
https://scholar.google.com/scholar?hl=ru&as_sdt=0%2C5&q=wosjournals.com&btnG
https://www.researchgate.net/profile/Worldly-Knowledge
https://journalseeker.researchbib.com/view/issn/3030-332X
96
Thus, regular testing of peripheral blood parameters is an important tool in a
comprehensive approach to the treatment and management of patients with RA. These data allow
not only to diagnose and monitor the course of the disease, but also to promptly identify possible
complications, thereby improving the outcome of treatment and the quality of life of patients.
Further research is needed to better understand the relationship between clinical manifestations
of RA and changes in peripheral blood, which may facilitate the development of more
personalized and effective treatments.
(REFERENCES):
1.
Firestein, G. S., & McInnes, I. B.
(2017). Rheumatoid arthritis. Lancet, 388(10055), 2023-
2038.
DOI: 10.1016/S0140-6736(17)31429-0
— Обзор патофизиологии, диагностики и лечения ревматоидного артрита, включая
роль биомаркеров и изменения в периферической крови.
2.
Kochi, Y., Yamada, R., & Okada, Y.
(2017). Genetic and epigenetic mechanisms of
rheumatoid arthritis. Nature Reviews Rheumatology, 13(11), 673-689.
DOI: 10.1038/nrrheum.2017.128
— Исследование генетических и эпигенетических факторов, которые могут повлиять
на изменения в крови при РА.
3.
Pincus, T., & Swearingen, C.
(2005). Rheumatoid arthritis and anemia: A review.
Seminars in Arthritis and Rheumatism, 35(2), 120-128.
DOI: 10.1016/j.semarthrit.2005.02.003
—
Обзоранемииприревматоидномартрите,
еёпатофизиологияирольвклиническомтечениизаболевания.
4.
Szekanecz, Z., & Besenyei, T.
(2013). The immune system in rheumatoid arthritis. In:
Klippel JH, et al. (Eds.), Primer on the Rheumatic Diseases (14th ed.). Springer.
ISBN: 978-1-4614-6435-8
— Влияние аутоиммунной активности на периферическую кровь при РА.
5.
López-Long, J. J., & Castañeda, S.
(2016). The role of biomarkers in rheumatoid arthritis.
Rheumatology International, 36(4), 531-537.
DOI: 10.1007/s00296-016-3517-7
— Оценка биомаркеров воспаления в крови при РА, включая СОЭ, СРБ и
специфические антитела.
6.
Cutolo, M., & Straub, R. H.
(2017). The role of the immune system in the pathogenesis of
rheumatoid arthritis. European Journal of Immunology, 47(9), 1496-1504.
DOI: 10.1002/eji.201747397
— Описание иммунных механизмов, влияющих на показатели крови у больных РА.
