https://doi.org/10.4081/reumatismo.2025.1682
Coexisting rheumatoid arthritis and sickle cell disease: case series and literature review
Submitted: 9 November 2023
Accepted: 13 July 2024
Published: 7 January 2025
Accepted: 13 July 2024
Abstract Views: 197
PDF: 79
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Rheumatoid arthritis (RA) is rarely reported among patients with sickle cell disease (SCD). RA treatment in these patients is believed to be more challenging due to fear of increasing the risk of infection and complications of SCD. We are reporting 7 patients with concurrent SCD and RA. The average age at the time of the diagnosis of RA was 33.3±12.6 years (ranging from 16 to 53 years), and most were women (5/7). Most of the patients were positive for rheumatoid factor (6/7) or anticyclic citrullinated peptide (6/7). Four patients were treated with hydroxyurea. The most used antirheumatic drugs were methotrexate (7/7), biologic agents (5/7), and prednisone (4/7). Two patients were in remission, four had low and one had high disease activity. Four patients (4/7) had avascular necrosis, two in the shoulders and two in the hip joints. Four patients had emergency visits or hospitalizations within one year of the diagnosis of RA, but none had blood transfusions, infections, or death. The start of antirheumatic medication was not associated with an increased risk of infection, blood transfusions, emergency visits, or hospitalizations, nor with a worsening of laboratory measures. The findings suggest that the treatment of RA in patients with SCD should follow the same strategy as in patients without SCD. However, treatment should be individualized according to the individual patient's risk of infection and SCD complications.
Kavanagh PL, Fasipe TA, Wun T. Sickle cell disease: a review. JAMA 2022; 328: 57-68.
DOI: https://doi.org/10.1001/jama.2022.10233
Brandow AM, Liem RI. Advances in the diagnosis and treatment of sickle cell disease. J Hematol Oncol 2022; 15: 20.
DOI: https://doi.org/10.1186/s13045-022-01237-z
Abu-Shaheen A, Dahan D, Henaa H, et al. Sickle cell disease in gulf cooperation council countries: a systematic review. Expert Rev Hematol 2022; 15: 893-909.
DOI: https://doi.org/10.1080/17474086.2022.2132225
Memish ZA, Saeedi MY. Six-year outcome of the national premarital screening and genetic counseling program for sickle cell disease and β-thalassemia in Saudi Arabia. Ann Saudi Med 2011; 31: 229-35.
DOI: https://doi.org/10.5144/0256-4947.2011.229
Helvaci MR, Abyad A, Pocock L. What a low prevalence of rheumatoid arthritis in sickle cell diseases. World Family Med 2018; 16: 32-7.
DOI: https://doi.org/10.5742/MEWFM.2018.93485
McFarlane IM, Ozeri DJ, Pathiparampil J, Sanchez R, Levinson J, Barrett-Campbell O, et al. Prevalence and clinical characteristics of rheumatoid arthritis in an inner city population with sickle cell disease. Rheumatology 2017; 7: 218.
DOI: https://doi.org/10.4172/2329-8731.1000218
Adelowo O, Edunjobi AS. Juvenile idiopathic arthritis coexisting with sickle cell disease: two case reports. BMJ Case Rep 2011; 2011: bcr1020114889.
DOI: https://doi.org/10.1136/bcr.10.2011.4889
Eberhard BA. Coexistent sickle cell disease and juvenile rheumatoid arthritis: 2 cases with delayed diagnosis and severe destructive arthropathy. J Rheumatol 2002; 29: 1802.
Nistala K, Murray KJ. Co-existent sickle cell disease and juvenile rheumatoid arthritis. Two cases with delayed diagnosis and severe destructive arthropathy. J Rheumatol 2001; 28: 2125-8.
Michel M, Habibi A, Godeau B, Bachir D, Lahary A, Galacteros F, et al. Characteristics and outcome of connective tissue diseases in patients with sickle-cell disease: report of 30 cases. Semin Arthritis Rheum 2008; 38: 228-40.
DOI: https://doi.org/10.1016/j.semarthrit.2007.10.003
McFarlane IM, Ozeri DJ, Saperstein Y, Alvarez MR, Leon SZ, Koci K, et al. Rheumatoid arthritis in sickle-cell population: pathophysiologic insights, clinical evaluation and management. Rheumatology 2017; 7: 225.
DOI: https://doi.org/10.4172/2161-1149.1000225
Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 2010; 62: 2569-81.
DOI: https://doi.org/10.1002/art.27584
Kimyon G, İlhan G. Is the treatment of inflammatory arthritis different in sickle cell disease? Turk J Med Sci 2022; 52: 1721-8.
DOI: https://doi.org/10.55730/1300-0144.5515
Sharma S, B M R. Rheumatoid arthritis veiled by sickle beta-thalassemia: a rare immunological association delaying diagnosis. Cureus 2021; 13: e17378.
DOI: https://doi.org/10.7759/cureus.17378
Roizenblatt S, Cabañas-Pedro AC, Figueiredo MS. Rheumatoid arthritis and sickle cell disease: a potential association. Br J Haematol 2020; 191: e25-8.
DOI: https://doi.org/10.1111/bjh.16952
Muthu J, Ali M, James-Goulbourne T. Differentiating rheumatoid arthritis related musculoskeletal pain in patients with concurrent sickle cell disease: a case series and literature review. J Med Cases 2016; 7: 334-40.
DOI: https://doi.org/10.14740/jmc2602e
Manappallil RG. Sickle cell crisis in a patient with rheumatoid arthritis: a case report. Asian Journal of Bio-Medical Research 2016; 2: 15.
Leung MH, Hughes M, Lane J, et al. Severe disability in a patient with rheumatoid arthritis and sickle cell anemia: an underreported, but yet a potentially treatable combination of diseases. J Clin Rheumatol 2015; 21: 458-9.
DOI: https://doi.org/10.1097/RHU.0000000000000326
Arana B, Gudiño PA, Cruz EA. Probable artritis reumatoide en un paciente con enfermedad de células falciformes. Rev Colomb Reumatol 2006; 13: 86-90.
Ferreira de Matos C, Comont T, Castex MP, Lafaurie M, Walter O, Moulis G, et al. Risk of vaso-occlusive episodes in patients with sickle cell disease exposed to systemic corticosteroids: a comprehensive review. Expert Rev Hematol 2022; 15: 1045-54.
DOI: https://doi.org/10.1080/17474086.2022.2149488
Darbari DS, Fasano RS, Minniti CP, Castro OO, Gordeuk VR, Taylor JGt, et al. Severe vaso-occlusive episodes associated with use of systemic corticosteroids in patients with sickle cell disease. J Natl Med Assoc 2008; 100: 948-51.
DOI: https://doi.org/10.1016/S0027-9684(15)31410-3
Griffin TC, McIntire D, Buchanan GR. High-dose intravenous methylprednisolone therapy for pain in children and adolescents with sickle cell disease. N Engl J Med 1994; 330: 733-7.
DOI: https://doi.org/10.1056/NEJM199403173301101
How to Cite
Alqethami, A., Alsaeedi, S., Felemban, S., & Qadi, A. (2025). Coexisting rheumatoid arthritis and sickle cell disease: case series and literature review. Reumatismo. https://doi.org/10.4081/reumatismo.2025.1682
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