OBJECTIVE--To investigate the expression of rheumatoid arthritis (RA) in Jewish Israeli patients according to ethnic origin. METHODS--RA patients who were seen in a primary public rheumatology clinic were divided into two groups according to ethnic origin (Sepharadic or Askenazi) and subjected to a cross sectional study. The two groups were compared for history, physical status, and radiographic and laboratory variables. The entire study population was again divided into two groups according to formal educational level, and these were also compared for the same variables as above. RESULTS--The patients of Sepharadic origin had significantly more pathological recordings of pain and fatigue, and greater Ritchie scores than those of Askenazi origin. The Sepharadic group patients were younger, had a lower educational level, and were predominantly female. The more educated group recorded significantly less pathological pain and fatigue, and had smaller Ritchie scores. Functional capacity and global disease severity, assessed by physician and patient, were also reduced in the more educated group. On multiple regression analysis, ethnic origin was found to be independently related to functional class. Education was found to be independently related to the Ritchie score. CONCLUSIONS--Disease manifestations in Jewish RA patients of Sepharadic origin are more serious compared with those in patients of Askenazi origin. In addition, low educational level is related to more severe disease manifestations in Israeli RA patients.
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