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Degenerative Joint Disease
The collagen diseases are so called because in all of them abnormalities develop in the collagen-containing connective tissue. These diseases are primarily generalized or systemic, frequently accompanied by joint complaints. The latter may be trivial in comparison to the systemic problems or may be severe enough to simulate rheumatoid arthritis. One of these diseases, systemic lupus erythematosus (SLE) may affect any structure or organ in the body. Some sort of overlap with rheumatoid arthritis is suggested by the fact that one-quarter of those with SLE have positive serological tests for rheumatoid factor, and perhaps as many patients with rheumatoid arthritis have positive L.E. cell tests. In another collagen disease, generalized scleroderma, the skin becomes thickened and tight. Similar changes occur in other organs, particularly the gastrointestinal tract.
Rheumatic fever often is classified with the collagen diseases. It has certain similarities to rheumatoid arthritis, as the name suggests, but the differences are more impressive. In both conditions, arthritis and subcutaneous nodules occur, and inflammation of the pericardium is frequent. Nevertheless the joint manifestations of rheumatic fever typically are evanescent, while those of rheumatoid arthritis are more persistent. The reverse is true of cardiac involvement in the two disorders. There is no compelling evidence that streptococcal infection is an important causative factor in rheumatoid arthritis, but it appears well established in rheumatic fever.
Arthritis more or less resembling rheumatoid arthritis occurs in roughly one-fourth of youngsters who lack gamma globulins in the blood. In this circumstance there is a deficit in the body's mechanisms for forming antibodies. This has sometimes been cited as an argument against the hypothesis holding that rheumatoid arthritis results from hypersensitivity.
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