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Smoke gets in your joints?
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Two of the commonest causes of death in patients with rheumatoid arthritis (RA) are ischaemic heart disease and respiratory infection, both of which should be exacerbated by cigarette smoking. I shall not insult the readership of the Annals by listing the many other reasons why patients with RA should not smoke. The paper by Saag et al, in this issue suggests yet another reason that we may not have thrust persuasively at our patients to date.1 This is that smoking may aggravate their RA.
The aetiology of RA and pathogenesis of progression to severe RA seem
to share much in common. For example being female predisposes to RA,
and is associated with more severe articular disease.2 Being seropositive for rheumatoid factor (RF) associates with RA, and
the higher the titre the more severe the RA.3 Possessing the shared epitope predisposes to RA, and the presence of these alleles
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This article has been cited by other articles:
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Hutchinson, D, Shepstone, L, Moots, R, Lear, J T, Lynch, M P
(2001). Heavy cigarette smoking is strongly associated with rheumatoid arthritis (RA), particularly in patients without a family history of RA. Ann Rheum Dis
60: 223-227
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Heliövaara, M, Aho, K, Knekt, P, Impivaara, O, Reunanen, A, Aromaa, A
(2000). Coffee consumption, rheumatoid factor, and the risk of rheumatoid arthritis. Ann Rheum Dis
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AHO, K, HELIÖVAARA;, M, JAMES, W. H
(1998). Ankylosing spondylitis: evidence for a non-HLA-B*27 protective effect.. Ann Rheum Dis
57: 263-264
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Connective tissue disease
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Degenerative joint disease
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Musculoskeletal syndromes
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