最新リウマチ情報
03/07 Rheumatology Conference: South Carolina Rheumatism Society 2019 Annual Meeting
03/19 PE firm to acquire orthopedic, anti-rheumatism pharmaceutical company ? 4 insights
03/15 Blackstone (BX) Reports Acquisition of AYUMI Pharmaceutical Corp.
03/23 Local shrub now top candidate for new cancer drug
09/12 Palindromic rheumatism: What it is, symptoms, and outlook
03/23 Bill Uhrich's Flashback Friday: An anaconda in Reading, a St. Patrick's Day tryst and more
03/23 William N. Kelley, MD, MACP, Recognized for Excellence in Medicine
04/24 Controversy persists for palindromic rheumatism: RA precursor or distinct entity?
03/12 Mystery solved -- biologists in Dresden explain the genetic origins of the saffron crocus
03/17 Think the snow and cold were bad this winter? In 1969, Spokane saw 3 1/2 feet on the ground
03/23 A health retreat in the Himalayas
03/15 Pro Rata
03/03 Cancer drugs shed light on rheumatism
11/23 Tiger Bone Wine
06/08 Samumed Announces Multiple Presentations at the European League Against Rheumatism (EULAR) 2018 Annual Congress
06/20 Samumed Presents Clinical and Preclinical Data at European League Against Rheumatism (EULAR) 2018 Annual Congress
10/10 Rheumatoid arthritis sufferers can now live a "normal" life
11/07 Why an English Museum Has a Collection of Magic Potatoes
06/14 European League Against Rheumatism (EULAR) Congress 2017
12/14 Worth the sting: Cuba's scorpion pain remedy
06/15 Gum disease may be a key initiator of rheumatoid arthritis related autoimmunity: Significantly higher prevalence of gum disease found in individuals at risk of rheumatoid arthritis compared to healthy controls
04/01 The Prescription for Rheumatism Used to Be to Sit Inside a Rotting Whale for 30 Hours
09/04 What is autoimmune arthritis? Symptoms and treatment
10/23 Rashmi Diagnosed with Rheumatism!
06/13 Once Educated, Patients Generally Receptive to Switching to Biosimilars
10/02 Medical Marijuana May Treat Rheumatism Better Than Opioids
12/19 The Marvelous Mrs. Maisel Season 2 Episode 9 Recap
06/15 New treatment lenebasum shows promise for diffuse cutaneous systemic sclerosis (dcSSc)
12/13 Future
06/26 Does RA Have a Prodrome? | Medpage Today
10/16 Rashmi Gautam opens up on weight gain, ageing and getting diagnosed with rheumatism
10/29 Symbol of the state: Empress Michiko's concern for the public
06/14 NSAID Use Mediates CVD Risk in Osteoarthritis
06/13 NSAIDs shown to have causal role in cardiovascular risk of patients with osteoarthritis
03/28 Drug compound shows promise against rheumatoid arthritis
08/10 Understanding a Desert Menace
12/05 Rheumatism treatment effective even when the use of biological agents is slightly delayed
01/31 A Sand Bath in Merzouga ? A New Treatment for Rheumatism and Neuromuscular Pain
09/17 Rheumatoid arthritis and pregnancy: Advice, effects, and planning
03/07 Causes of death in rheumatoid arthritis patients
06/17 Low-Dose Biosimilar Rituximab Is Effective in Treating RA
12/09 Midge shows just how far she's come when she gets her first TV gig in The Marvelous Mrs. Maisel
05/01 Palindromic rheumatism (a cause of rheumatoid arthritis): Causes, symptoms, and treatment
05/14 EULAR recommendations for pain management in inflammatory arthritis and osteoarthritis
06/14 Combining NSAIDs and TNFi may reduce radiographic progression in ankylosing spondylitis
08/14 Top Ways You Might Worsen Rheumatoid Arthritis Symptoms
04/19 5 Common Types of Arthritis
06/16 Passive smoking in childhood linked to rheumatoid arthritis: Smoking also speeds up disease progression in ankylosing spondylitis
03/31 Australians bathed inside rotting whales to 'cure' rheumatism
06/18 Rheumatoid arthritis awareness week: Palindromic rheumatism, rheumatoid arthritis and feet, rheumatoid arthritis and depression
06/18 Eye on Pharma: Progress for Celltrion on Trastuzumab and Subcutaneous Infliximab Biosimilars
05/07 Weekly health news roundup: Palindromic rheumatism, headache and constipation, transient global amnesia
10/08 British soldiers' WW1 trench battles with STDs, rheumatism and wasp stings
03/30 Bizarre whale treatment for rheumatism revealed
02/25 Failure to act on early signs of rheumatism could prove fatal
04/18 EULAR Releases Recommendations for Managing Behcet Syndrome
03/22 Rheumatoid Arthritis and Vitamin D
06/04 The art of healing: five medicinal plants used by Aboriginal Australians
01/20 Epigenetics explains rheumatism? Genes and their regulatory 'tags' conspire to promote rheumatoid arthritis
08/17 Archaeologists Are Excavating Sheffield Castle, One-Time Prison of Mary, Queen of Scots
06/09 Diabetes more frequent in children with chronic rheumatic disease: Further research into link between Type 1 diabetes and Juvenile Inflammatory Arthritis may lead to new treatments
03/28 Using Medical Marijuana/Cannabis for Fibromyalgia
06/04 Baricitinib, Approved By FDA, Is a New Rheumatoid Arthritis Drug To Be Sold as Olumiant
06/16 New effective treatments for psoriatic arthritis patients: Promising data to support two new drug classes
06/12 63 Percent Of Rheumatoid Arthritis Patients Suffer Psychiatric Disorders, With Depressive Spectrum Conditions Most Likely
11/16 Environmental factors may trigger lupus onset and progression
02/17 Coping with Rheumatism
06/15 Tendon Inflammation in the Hand Predicts Future Arthritis
10/21 Health Benefits of Turmeric
05/27 Is Cannabis an Effective Treatment for Rheumatoid Arthritis?
08/18 Cannabis Helped This Ontario Mom Get Off The Park Bench And Play With Her Kids
07/18 Fibromyalgia Guidelines Released by EULAR
02/04 Why Venice Was Nothing More Than A Drippy Adriatic City
06/11 Non-steroidal anti-inflammatory drugs inhibit ovulation after just 10 days
12/19 Arthritis, rheumatism and total joint arthroplasty: an interview with Dr Ravi and Dr Hawker
07/16 Five more Tetra Pak packages approved by the Swedish Rheumatism Association
12/05 ‘Kaymito’ for diarrhea, ‘gabi’ for rheumatism?the cures you need may be in your garden
05/29 Scientists Link a Gene Mutation to Rheumatic Heart Disease
09/22 The history of anti-rheumatic medicines is one of hope and disaster
07/20 How effective is total knee replacement in patients with rheumatoid arthritis?
01/06 Gout, Scurvy, Rickets, and Other Victorian Diseases Are Making a Comeback, But Largely Preventable, Too
04/23 Medical Mystery: Theodore Roosevelt and the River of Doubt
06/17 Triple Therapy as Good as Biologics for Rheumatoid Arthritis
12/23 Collecting bottle caps can help those with rheumatism
05/08 Welby launches three more apps for pharmas J&J, UCB, and Nippon Shinyaku
06/09 Blood test can help predict RA treatment response: Important step towards introduction of personalised medicine in rheumatology
03/31 Ancient Egyptian Rheumatism And Gout Medicine, ‘Colchicine,’ Reduces Heart Inflammation
01/30 Lumbar disc degeneration more likely in overweight and obese adults
06/09 Biosimilar switching not suitable for all patients: Patients with antibodies to biological infliximab are less likely to benefit from infliximab biosimilar (CT-P13)
01/05 Stem Cell Therapy a Possible Treatment for Rheumatoid Arthritis
01/02 The risk of osteoarthritis and index to ring finger length ratio
01/12 EULAR Guidelines Updated for Early Arthritis
01/27 Living with an invisible disability
04/02 Claiming a seat at the table: United Rheumatology meeting gives independent practices a voice
08/27 Prolonged disability due to post chikungunya arthritis
06/13 Sjögren's Syndrome significantly increases risk of heart attack
06/11 Physical trauma associated with onset of psoriatic arthritis among psoriasis patients
08/29 Nigeria: Pneumonia, Rheumatism Worry Jos Residents Living On Rocks
09/06 José María Olazábal ready to make comeback following recovery from rheumatism
04/19 Rheumatoid arthritis cure: Symptoms halted by doing THIS (it could prevent joint damage)
03/19 PE firm to acquire orthopedic, anti-rheumatism pharmaceutical company ? 4 insights
03/15 Blackstone (BX) Reports Acquisition of AYUMI Pharmaceutical Corp.
03/23 Local shrub now top candidate for new cancer drug
09/12 Palindromic rheumatism: What it is, symptoms, and outlook
03/23 Bill Uhrich's Flashback Friday: An anaconda in Reading, a St. Patrick's Day tryst and more
03/23 William N. Kelley, MD, MACP, Recognized for Excellence in Medicine
04/24 Controversy persists for palindromic rheumatism: RA precursor or distinct entity?
03/12 Mystery solved -- biologists in Dresden explain the genetic origins of the saffron crocus
03/17 Think the snow and cold were bad this winter? In 1969, Spokane saw 3 1/2 feet on the ground
03/23 A health retreat in the Himalayas
03/15 Pro Rata
03/03 Cancer drugs shed light on rheumatism
11/23 Tiger Bone Wine
06/08 Samumed Announces Multiple Presentations at the European League Against Rheumatism (EULAR) 2018 Annual Congress
06/20 Samumed Presents Clinical and Preclinical Data at European League Against Rheumatism (EULAR) 2018 Annual Congress
10/10 Rheumatoid arthritis sufferers can now live a "normal" life
11/07 Why an English Museum Has a Collection of Magic Potatoes
06/14 European League Against Rheumatism (EULAR) Congress 2017
12/14 Worth the sting: Cuba's scorpion pain remedy
06/15 Gum disease may be a key initiator of rheumatoid arthritis related autoimmunity: Significantly higher prevalence of gum disease found in individuals at risk of rheumatoid arthritis compared to healthy controls
04/01 The Prescription for Rheumatism Used to Be to Sit Inside a Rotting Whale for 30 Hours
09/04 What is autoimmune arthritis? Symptoms and treatment
10/23 Rashmi Diagnosed with Rheumatism!
06/13 Once Educated, Patients Generally Receptive to Switching to Biosimilars
10/02 Medical Marijuana May Treat Rheumatism Better Than Opioids
12/19 The Marvelous Mrs. Maisel Season 2 Episode 9 Recap
06/15 New treatment lenebasum shows promise for diffuse cutaneous systemic sclerosis (dcSSc)
12/13 Future
06/26 Does RA Have a Prodrome? | Medpage Today
10/16 Rashmi Gautam opens up on weight gain, ageing and getting diagnosed with rheumatism
10/29 Symbol of the state: Empress Michiko's concern for the public
06/14 NSAID Use Mediates CVD Risk in Osteoarthritis
06/13 NSAIDs shown to have causal role in cardiovascular risk of patients with osteoarthritis
03/28 Drug compound shows promise against rheumatoid arthritis
08/10 Understanding a Desert Menace
12/05 Rheumatism treatment effective even when the use of biological agents is slightly delayed
01/31 A Sand Bath in Merzouga ? A New Treatment for Rheumatism and Neuromuscular Pain
09/17 Rheumatoid arthritis and pregnancy: Advice, effects, and planning
03/07 Causes of death in rheumatoid arthritis patients
06/17 Low-Dose Biosimilar Rituximab Is Effective in Treating RA
12/09 Midge shows just how far she's come when she gets her first TV gig in The Marvelous Mrs. Maisel
05/01 Palindromic rheumatism (a cause of rheumatoid arthritis): Causes, symptoms, and treatment
05/14 EULAR recommendations for pain management in inflammatory arthritis and osteoarthritis
06/14 Combining NSAIDs and TNFi may reduce radiographic progression in ankylosing spondylitis
08/14 Top Ways You Might Worsen Rheumatoid Arthritis Symptoms
04/19 5 Common Types of Arthritis
06/16 Passive smoking in childhood linked to rheumatoid arthritis: Smoking also speeds up disease progression in ankylosing spondylitis
03/31 Australians bathed inside rotting whales to 'cure' rheumatism
06/18 Rheumatoid arthritis awareness week: Palindromic rheumatism, rheumatoid arthritis and feet, rheumatoid arthritis and depression
06/18 Eye on Pharma: Progress for Celltrion on Trastuzumab and Subcutaneous Infliximab Biosimilars
05/07 Weekly health news roundup: Palindromic rheumatism, headache and constipation, transient global amnesia
10/08 British soldiers' WW1 trench battles with STDs, rheumatism and wasp stings
03/30 Bizarre whale treatment for rheumatism revealed
02/25 Failure to act on early signs of rheumatism could prove fatal
04/18 EULAR Releases Recommendations for Managing Behcet Syndrome
03/22 Rheumatoid Arthritis and Vitamin D
06/04 The art of healing: five medicinal plants used by Aboriginal Australians
01/20 Epigenetics explains rheumatism? Genes and their regulatory 'tags' conspire to promote rheumatoid arthritis
08/17 Archaeologists Are Excavating Sheffield Castle, One-Time Prison of Mary, Queen of Scots
06/09 Diabetes more frequent in children with chronic rheumatic disease: Further research into link between Type 1 diabetes and Juvenile Inflammatory Arthritis may lead to new treatments
03/28 Using Medical Marijuana/Cannabis for Fibromyalgia
06/04 Baricitinib, Approved By FDA, Is a New Rheumatoid Arthritis Drug To Be Sold as Olumiant
06/16 New effective treatments for psoriatic arthritis patients: Promising data to support two new drug classes
06/12 63 Percent Of Rheumatoid Arthritis Patients Suffer Psychiatric Disorders, With Depressive Spectrum Conditions Most Likely
11/16 Environmental factors may trigger lupus onset and progression
02/17 Coping with Rheumatism
06/15 Tendon Inflammation in the Hand Predicts Future Arthritis
10/21 Health Benefits of Turmeric
05/27 Is Cannabis an Effective Treatment for Rheumatoid Arthritis?
08/18 Cannabis Helped This Ontario Mom Get Off The Park Bench And Play With Her Kids
07/18 Fibromyalgia Guidelines Released by EULAR
02/04 Why Venice Was Nothing More Than A Drippy Adriatic City
06/11 Non-steroidal anti-inflammatory drugs inhibit ovulation after just 10 days
12/19 Arthritis, rheumatism and total joint arthroplasty: an interview with Dr Ravi and Dr Hawker
07/16 Five more Tetra Pak packages approved by the Swedish Rheumatism Association
12/05 ‘Kaymito’ for diarrhea, ‘gabi’ for rheumatism?the cures you need may be in your garden
05/29 Scientists Link a Gene Mutation to Rheumatic Heart Disease
09/22 The history of anti-rheumatic medicines is one of hope and disaster
07/20 How effective is total knee replacement in patients with rheumatoid arthritis?
01/06 Gout, Scurvy, Rickets, and Other Victorian Diseases Are Making a Comeback, But Largely Preventable, Too
04/23 Medical Mystery: Theodore Roosevelt and the River of Doubt
06/17 Triple Therapy as Good as Biologics for Rheumatoid Arthritis
12/23 Collecting bottle caps can help those with rheumatism
05/08 Welby launches three more apps for pharmas J&J, UCB, and Nippon Shinyaku
06/09 Blood test can help predict RA treatment response: Important step towards introduction of personalised medicine in rheumatology
03/31 Ancient Egyptian Rheumatism And Gout Medicine, ‘Colchicine,’ Reduces Heart Inflammation
01/30 Lumbar disc degeneration more likely in overweight and obese adults
06/09 Biosimilar switching not suitable for all patients: Patients with antibodies to biological infliximab are less likely to benefit from infliximab biosimilar (CT-P13)
01/05 Stem Cell Therapy a Possible Treatment for Rheumatoid Arthritis
01/02 The risk of osteoarthritis and index to ring finger length ratio
01/12 EULAR Guidelines Updated for Early Arthritis
01/27 Living with an invisible disability
04/02 Claiming a seat at the table: United Rheumatology meeting gives independent practices a voice
08/27 Prolonged disability due to post chikungunya arthritis
06/13 Sjögren's Syndrome significantly increases risk of heart attack
06/11 Physical trauma associated with onset of psoriatic arthritis among psoriasis patients
08/29 Nigeria: Pneumonia, Rheumatism Worry Jos Residents Living On Rocks
09/06 José María Olazábal ready to make comeback following recovery from rheumatism
04/19 Rheumatoid arthritis cure: Symptoms halted by doing THIS (it could prevent joint damage)
リウマチとは
リウマチとは
- 「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
日本全国でリウマチに悩む人は１００万人ともいわれ、その数は社会の高齢化にともない、年々増加しています。
リウマチ専門医・病院・クリニック検索
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病院
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。しばしば血管、心臓、肺、皮膚、筋肉といった全身臓器にも障害が及びます。
関節リウマチの原因
関節リウマチの原因
- 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
関節リウマチの診断・早期診断(関節リウマチが疑われる症状)
リウマチの診断
多くの病院では、1987年米国リウマチ学会によって提唱された分類基準を参考にして、関節リウマチかどうかの診断します。（1994年に日本リウマチ学会が提唱した「早期関節リウマチの診断基準」を使う病院もあります。）
- 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
上記の7項目のうち、4項目以上にあてはまる場合を関節リウマチとする、とされています。
早期診断・リウマチが疑われる症状
早期のリウマチ患者では上記の基準に当てはまらないことも多くあります。以下は、リウマチを疑ったほうがよいとされる症状です。
- 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）
関節リウマチの症状
関節リウマチの症状
- 関節炎
- 初期の症状「朝のこわばり(morning stiffness)」
朝起きてから、手をにぎることが困難であり、文字通りこわばります。
5-10分程度のこわばりは他の疾患でも診られますが、1時間以上も続くこわばりであれば関節リウマチまたは他のリウマチ性疾患の可能性が高い様です。
- 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。
- 初期の症状「朝のこわばり(morning stiffness)」
- 血管
血管病変を合併する場合には、全身にくまなく留意しなければなりません。
心臓では狭心症・心筋梗塞、肺では肺高血圧症、腎臓では糸球体硬化症、脳では脳梗塞が起こりえます。
- 眼
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
間質性肺炎、気道病変、胸膜病変、リウマチ結節、血管病変、睡眠時無呼吸症候群（顎関節病変、輪状披裂関節病変）などを合併することがあります。
- 心臓
心膜炎やリウマトイド結節を生じることもあります。
- 神経
関節リウマチに伴い血管炎が生ずれば、それに伴い多発単神経炎が起こる事があります。
- 皮膚
圧のかかる部位に、リウマチ結節と呼ばれる病変や、皮下出血などもみられることがあります。
- 血液
重症の関節リウマチ患者においては、脾腫、白血球（好中球のみ）減少をきたします。
関節リウマチの治療
関節リウマチの治療
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。痛みに対する対症療法として非ステロイド系消炎鎮痛剤（NSAIDs）などを用います。
- 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。
欧米では抗マラリア薬であるヒドロキシクロロキンも使用され、免疫抑制薬であるアザチオプリン（イムラン®）、シクロスポリン（ネオーラル®）も効果が示されています。
- 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
インフリキシマブ（レミケード®）、アダリムマブ(ヒュミラ®)、トシリズマブ(アクテムラ®)、エタネルセプト（エンブレル®）、アバタセプト(オレンシア®)は新しく開発されています。
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
各ビタミンの相互作用により、血中ビオチン値の上昇を目的とし、脾臓細胞における、免疫不全症の改善治癒を行うための治療方法です。
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。