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06/03 Navidea Biopharmaceuticals Announces Acceptance of Abstract for Presentation at the European League Against Rheumatism (EULAR) Congress
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09/23 Green buildings only hope in post-pandemic era
04/16 Rheumatic disease and COVID-19: initial data from the COVID-19 Global Rheumatology Alliance provider registries
07/07 Treatment with methotrexate and risk of lung disease in patients with rheumatoid arthritis
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  • 「リウマチ」、「リューマチ」、「リュウマチ」、「ロイマチ」とよばれます。
  • 英語では、"Rheumatism", "Rheuma" と表記します。
  • からだのあちこちの関節に炎症が起こり、関節が腫れて痛む病気です。
  • 進行すると関節の変形や機能障害(使えなくなること)が起こります。
  • おもに、下の2つが代表的な疾患とされます。
    • 関節リウマチ と、
    • リウマチ熱




病院 医院、
周辺地図をみる 現在地を記憶する 現在地をリセット

関節リウマチ ( Rheumatoid Arthritis, RA )

関節リウマチ ( Rheumatoid Arthritis, RA )
関節リウマチ(Rheumatoid Arthritis:RA)は、自己の免疫が主に手足の関節を侵し、これにより関節痛、関節の変形が生じる代表的な膠原病の一つで、炎症性自己免疫疾患です。


  • 完全には病気の原因は究明されていません。
  • 自己の免疫系(細菌などから体を防御するシステム)に異常があることが知られています。
  • 免疫細胞が攻撃を始める根本原因は不明です。
    • 遺伝的なもの(遺伝子が関係する)
    • 感染した微生物(ウイルスや細菌)の影響
    • 妊娠や出産など女性ホルモンの変化


  • 朝のこわばりが、少なくとも1時間以上にわたってみられる
  • 3つ以上の関節に炎症による腫れがみられる
  • 手首や手指のつけ根の関節、手指の第2関節に炎症による腫れがみられる
  • 左右対称の関節に炎症による腫れがみられる
  • 皮下結節(リウマトイド結節)がひじやひざなどにみられる
  • 血液検査でリウマトイド因子が陽性である
  • X線検査で手の関節に骨の萎縮などの変化がみられる

  • 関節の痛み、腫れがある
  • 特に朝に、関節がこわばる
  • 多くの関節に症状がある(3か所〜程度)
  • 左右対称に症状がある(例:右手指と左手指)


  • 関節炎
    • 初期の症状「朝のこわばり(morning stiffness)」
    • そのうち、関節痛がおこるようになり、手指や足指の関節がおかされ、次第に手首、肘、膝など体の中心に近い大きな関節の痛みを感じるようになります。
    • 関節痛は、手を動かすなど活動すると増強します。
    • 関節炎が進行すると、関節そのものが変性し、最終的には関節が破壊し尽くされ、骨と骨が直接接した強直という状態になります。
    • 手足の関節の他では、胸・腰の背骨はおかされないが首の背骨(頚椎)はおかされやすいようです。
    • 頚部痛を生じたり、脊髄損傷、また、鎖骨に関節痛が起こる事もあります。
  • 血管

  • 関節リウマチ患者には、ドライアイもよく見られ、目の内側にリウマトイド結節が生じることもあります。
  • 呼吸器
  • 心臓
  • 神経
  • 皮膚
  • 血液


現在の治療指針では関節リウマチの診断がついたら、出来るだけ早期に抗リウマチ薬(DMARDs), 生物学的製剤を用いることが推奨されています。


  • DMARDs(抗リウマチ薬)
    関節リウマチの病気の勢いそのものを弱める薬として、メトトレキサート(リウマトレックス®)、スルファサラジン(アザルフィジン®)、 ブシラミン(リマチル®)、レフルノミド(アラバ®)、ミゾリビン、タクロリムス(プログラフ®)が使用されます。
  • ステロイド
    臨床試験の結果、ステロイドもDMARDsと同様に、病気の進行を遅らせる効果を示すことがわかり、DMARDsのみよりもDMARDsにステロイドを加えたほうが 病気の進行をさらに遅らせるという研究結果も報告されています。
  • 抗サイトカイン療法
    これらはリウマチに対してきわめて強力な治療効果を示していますが、これらの薬剤は免疫応答に対する抑制効果が強く、しばしば感染症を引き起こすことがあり、 抗菌薬の併用などによる十分な予防を行う必要があります。
  • その他の研究段階の新しい治療法
    悪性リンパ腫に効果のあるリツキシマブ(リツキサン®)、抗生剤であるテトラサイクリン、高脂血症治療薬であるスタチン、多発性骨髄腫治療薬であるサリドマイドの効果や、 造血幹細胞移植の効果も検討されています。
  • ビオチン治療法
    今までは、免疫不全症の原因が不明であることから、対処療法薬の投与をおこなう寛解維持療法がおこなわれていましたが、昨今の研究で、免疫不全症の一部の原因が初めて特定され、 これにより、ビオチン治療が確立しました。

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