Seronegative arthritis (the prefix “-sero” is translated as blood serum) embraces a group of diseases related to different joints. These diseases have similar clinical characteristics and immunopathological mechanisms associated with each other.
So, what is seronegative arthritis?
Let us clarify the definition of the disease we deal with. Seronegative rheumatoid arthritis is a type of rheumatoid arthritis which is diagnosed on the basis of a special blood test which shows the absence of one of the key factors of the disease. There is no rheumatoid factor in the blood. Rheumatoid factor is formed by autoantibodies produced by the immune system. Rheumatoid factor is present in patients with rheumatoid arthritis. There is no rheumatoid factor in healthy people. Cases of arthritis with negative rheumatoid factor are related to seronegative arthritis, the one we are now talking about. Seronegative rheumatoid arthritis is quite a widespread type of the disease. It makes about 20 percent of all the patients with arthritis.
There are many types of seronegative arthritis, which are divided into 4 categories:
- seronegative rheumatoid arthritis;
- seronegative spondylarthritis (Bekhterev’s disease, psoriatic arthritis, Reiter’s disease, diseases associated with inflammatory bowel disease);
- reactive arthritis (streptococcal, Salmonella, and shigellosis arthritis);
- arthritis not associated with rheumatism (gynecological, oncology, and endocrine system diseases).
This classification determines all seronegative diseases. These diseases lead to inflammation in the joints. Arthrosis is the most common type of seronegative diseases. Doctors notice the tendency of the disease to affect elderly people. The older the person is, the greater the risk of joint damage is. The disease is usually treated with anti-inflammatory drugs but they tend to provoke a lot of side effects. Before taking any medication, it is always better to consult your doctor. The natural process of recovery is considered to be the best one but, unfortunately, such a scenario rarely works.
The nature of the inflammatory lesions of the joints varies. Depending on that fact, the types of arthritis are divided into two major groups:
- inflammatory arthritis;
- degenerative arthritis.
The inflammatory group includes seropositive/seronegative inflammatory arthritis and gout (synovial membrane of the joint gets inflamed).
Degenerative arthritis includes osteoarthrosis and traumatic arthritis (joint cartilage is damaged).
Seronegative Arthritis Causes
The best scientists of the world still cannot determine seronegative arthritis causes. Many people still get the diagnosis of undifferentiated arthritis which further turns into rheumatoid arthritis. Scientists have identified a number of predisposing factors that may lead to the occurrence of the disease. These are:
- external adverse effects (smoking, coal dust, infections: Epstein-Barr virus, parvovirus, retrovirus, bacterium);
- internal factors (genetic predisposition).
According to scientists, other causes of seronegative rheumatoid arthritis may include infectious disease, severe emotional distress, fatigue, and exhausting physical work.
Seronegative Arthritis Symptoms and Clinical Manifestations
There are certain peculiarities of the disease called seronegative rheumatoid arthritis. This type of the disease has a number of differences that occur in the beginning and in the course of the disease. Comparing to seropositive type of rheumatoid arthritis, the occurrence of seronegative type is always more acute. Often the disease is accompanied by fever, in which the body temperature fluctuation can reach 3-4 degrees. It is also accompanied by a clear increase of the lymph nodes, chills, muscle atrophy, weight loss, and anemia.
At the initial stage, this disease can affect only one joint. Several joints are likely to be affected asymmetrically as well. Comparing to other types of arthritis, this type more often affects large joints (especially knee joints).
With further development of the disease, the joints of the hands and feet get affected. Wrist joints are more prone to be affected than the phalangeal and lumbar joints.
Morning stiffness in seronegative form of the disease is less frequent and is less acute. Another peculiarity of this type of arthritis is the fact that there are no subcutaneous rheumatoid nodules and various manifestations of rheumatoid vasculitis rarely occur; peripheral lymph glands often increase.
Here are specific seronegative arthritis symptoms and signs:
- hip joint gets affected;
- changes of fibrous type predominate;
- contractures appear;
- the disease develops actively; there may be frequent relapses;
- early violation of joint function;
- rare or ill-defined lesions of metacarpophalangeal, metatarsophalangeal, interphalangeal joints;
- arthropathy, morning stiffness is weakly expressed;
- one-sided localization;
- symmetric polyarthritis develops throughout the year;
Seronegative arthritis is detected on X-ray. The X-ray also reveals:
- small foot deformities;
- ankylosing predominance over erosive process;
- ill-defined osteoporosis;
- in the 2 or 3 phase of the disease development, there is an imbalance between a serious injury of the wrist joints and minor changes of interphalangeal and metacarpophalangeal joints of the hand.
Extra-articular manifestations of seronegative rheumatoid arthritis are as follows:
- renal irritation;
- severe amyotrophy;
- development of generalized lymphadenopathy;
- violation of the general condition;
- fever, anemia;
- there is no rheumatoid factor in the blood;
- the affection of large (usually the knee) or asymmetric joints;
- no rheumatoid nodules;
- weight loss.
Excluding the symptoms mentioned above, seronegative rheumatoid arthritis proceeds similarly to the seropositive type of the disease.
Peculiarities of Seronegative Rheumatoid Arthritis Diagnosis
The key feature in the diagnosis of this very type of the disease is the fact that no rheumatoid factor is detected in blood during Waaler-Rose test or latex-test.
X-ray examination shows asymmetric erosive joint changes with early ankylosis of wrist joints.
ESR and other inflammatory indicators are also increased. Such symptoms contribute to finding the right diagnosis.
Seronegative Arthritis Treatment
Since there are two fundamentally different forms of the disease, their treatment varies considerably.
The therapeutic program will vary depending on the type of disease. Therefore, one cannot choose any means of seronegative arthritis treatment. Self-treatment is unacceptable in this case.
There are various options used to cure the disease. The main point of therapy is to slow down the process of joint destruction and to obtain permanent control over the inflammatory process. There are the following ways of seronegative arthritis treatment.
Seronegative arthritis treatment consists of 2 phases. Initially, the patient is prescribed symptomatic therapy which is aimed at eliminating the pain and stiffness. If patients experience fever, doctors use drugs containing ibuprofen which has anti-inflammatory, analgesic, and antipyretic properties. Topical therapy is also used to treat the disease. It includes a variety of ointments on the basis of non-steroidal anti-inflammatory drugs. A drawback of topical treatment is that the effect of such drugs doesn’t last long. A few hours after applying these drugs, the symptoms of the disease recur. Therefore, NSAIDs in the form of pills or injections are widely used to deal with the disease.
The next group of drugs used in the treatment of rheumatoid arthritis includes immunosuppressants. As long as the disease is of an autoimmune etiology, suppression of the immune system leads to the inhibition of destructive processes in the joint. Such remedies have a lot of side effects (in addition to the expensiveness of such treatment). There may be sometimes irreversible pathological changes of internal organs (liver and kidney mainly) due to the intake of such drugs.
Treatment of seronegative and seropositive rheumatoid arthritis is similar. It is often carried out by the same drugs. There is still one thing about seronegative arthritis. It is more difficult to cure this type of the disease than seropositive one. The disease is only easy to treat at the early stages. The situation may aggravate if a patient gets engaged in self-medication or uses methods of traditional medicine without consulting a doctor. Such experiments can be detrimental to the joints and other internal organs and systems as well.
Surgery in rheumatoid arthritis is used only in advanced forms when the joint is completely destroyed or fails to fulfill the majority of its functions.
Seronegative Arthritis Diet
The nature of arthritis inflammation has not been studied thoroughly, but it is known that the immune system begins to fight one’s own body. Its main purpose is the destruction of its own joints. To cure arthritis or eliminate its signs, it is necessary to use all possible methods of dealing with it. A properly organized seronegative arthritis diet aimed at stabilizing metabolism in the body is an extremely important factor for successful treatment.
A patient with seronegative arthritis should prefer food enriched with polyunsaturated fatty acids (vegetable oils, fatty sea fish). The diet should as well include fresh fruits and vegetables. One should limit products that have an irritant effect (spicy food, salty, and smoked products). The prognosis may be very favorable if the patient follows doctor’s prescriptions and avoids self-medication.