High frequency of rheumatic regional pain syndromes in first-degree relatives of patients with rheumatoid arthritis


First-degree relatives (FDR) of patients with rheumatoid arthritis (RA) have a higher risk for the development of RA. In the stages prior to the development of arthritis, nonspecific musculoskeletal (MSK) manifestations may occur. The aim of the study is to describe the frequency of rheumatic regional pain syndromes (RRPS) in FDR of RA patients. A cross-sectional study was carried out from July 2016 to September 2018. Parents, offspring, and siblings of RA patients completed the Community Oriented Program in the Rheumatic Diseases (COPCORD) questionnaire. Rheumatoid factor (RF) IgG, IgM, and IgA; anticitrullinated peptide antibodies (ACPAs); C-reactive protein (CRP); and erythrocyte sedimentation rate (ESR) were determined. All subjects with a positive COPCORD (defined by the presence of musculoskeletal pain) were evaluated and classified. Three hundred thirty-five FDRs participated, 75.8% were female, mean age of 44.15 years; 138 (41.2%) were diagnosed with at least one RRPS; 72 (21.5%) had rotator cuff tendinitis, 51 (15.2%) pes anserine bursitis, and 39 (11.6) lateral epicondylitis; RA was diagnosed in 24 (7.16%) subjects, undifferentiated arthritis (UA) in 30 (8.9%) and inflammatory arthralgia (AI) in 104 (31%). We found anti-CCP positivity in 6.8%, RF IgA in 22.3%, RF IgM in 48.6%, and RF IgG in 8.9%. The presence of RRPS was higher in this RA-FDR group compared to general population. Clinical evaluation of this risk group should include screening for RRPS.

Key Points
The frequency of rheumatic regional pain syndromes in first-degree relatives of patients with rheumatoid arthritis was 41%.
Rotator cuff tendinitis was detected in 21.5%, higher than reported in the Mexican population.
The presence of RRPS in this risk group could be considered as one of the first manifestations of RA.

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The authors would like to thank collaborators Jacqueline Rodríguez-Amado, Wendy Orzúa-de la Fuente, Ana Sofía Leal-Bramasco, César Vidal Elizondo-Solís, Juan Manuel Cantú-Martínez, Jorge Hermosillo-Villafranca, Jorge Rodríguez-Olivo, Elías Adán Godoy-Salinas, Karla A. Esquivel-Alvizu, Cassandra M. Skinner-Taylor, Diana Elsa Flores-Alvarado, Janett Carmen Riega-Torres, Andrés Mendiola-Jiménez, and Karen Martínez-Ojeda.

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Correspondence to Mario Alberto Garza-Elizondo.

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Pérez-Barbosa, L., Garza-Elizondo, M.A., Vega-Morales, D. et al. High frequency of rheumatic regional pain syndromes in first-degree relatives of patients with rheumatoid arthritis. Clin Rheumatol 39, 3303–3307 (2020). https://doi.org/10.1007/s10067-020-05029-z

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  • Autoimmunity
  • Relatives
  • Rheumatism
  • Rheumatoid arthritis
  • Shoulder pain