Treatment of the Patient With Rheumatoid Arthritis Refractory to Standard Therapy

Abstract

SELECTED CASEAT THE age of 23 years, following a pregnancy, a woman developed severe fatigue, morning stiffness, and marked swelling and tenderness of multiple peripheral joints. On presentation to her physician, she was found to have serum rheumatoid factor in a high titer, an elevated erythrocyte sedimentation rate, and an elevated level of C-reactive protein. Roentgenographic studies revealed diffuse periarticular demineralization without bony erosions. A diagnosis of rheumatoid arthritis was made.