Can rheumatoid arthritis come back after 10 years of remission?

Question

Hello doctor,

When I was a child, I had juvenile rheumatoid arthritis. After treatment, it eventually went into remission for almost ten years. Now, at 31, I am suddenly experiencing swollen fingers, morning stiffness, and knee pain again, especially after stressful weeks.

Can rheumatoid arthritis return at 31 after being in remission for ten years? Honestly, I thought that chapter of my life was over, and now I'm worried that the disease is coming back permanently.

Please guide.

Answer 1

Hello,

Welcome to icliniq.com.

I understand why you and your dad are concerned.

Rheumatoid arthritis can cause relapses and remission at an older age. It is important to first evaluate your condition by a thorough examination of your joints to determine if it is arthritis or another periarticular issue.

If clinical arthritis is present, then further investigation will be needed to see if this is rheumatoid arthritis or if another cause is possible, such as an autoimmune condition or viral arthritis. If rheumatoid arthritis is confirmed, management will have to be reinitiated with Methotrexate and a short course of steroids.

Relapsing rheumatoid arthritis in older adults usually persists, unlike the self-limited juvenile cases, so lifelong management may be necessary.

Treatment plan:

Methotrexate 25 mg weekly.
Folic acid 5 mg weekly.
Steroids 20 mg for 2 weeks, then gradually withdrawn.

You can go for a follow-up consultation after two months of management, with preventive measures including rest and cryotherapy.

A follow-up consultation is recommended after two months of management, along with preventive measures such as rest and cryotherapy.

I hope this explanation is clear and helpful.

If you have any further questions or need clarification, I am here to assist you.

Thank you for reaching out!