Early Seropositive Rheumatoid Arthritis Managed with Panchakarma and Shamana Therapy: A Case Report

Rheumatoid Arthritis (RA) is a chronic autoimmune disorder marked by synovitis, pain, swelling, and progressive joint damage. This case report describes Ayurvedic management of early seropositive RA in a 31‑year‑old female presenting with bilateral wrist involvement, metacarpophalangeal and proximal interphalangeal joint pain, swelling, tenderness, and morning stiffness. Diagnosis was confirmed by clinical features, laboratory tests, MRI, and ACR/EULAR 2010 criteria. Treatment included Panchakarma procedures: Koshthashodhan, Dhanyamla Parisheka, Valuka Sweda, Yoga Basti, and Jalaukavacharana, followed by Shamana therapy. Clinical improvement was observed with DAS28‑ESR reducing from 6.18 (high disease activity) to 2.86 (low activity). Laboratory parameters also improved: RA titre decreased from 37.8 IU/mL to 13.6 IU/mL, CRP from 14 mg/L to 5.2 mg/L, and ESR from 60 mm/hr to 40 mm/hr. This case highlights the potential of Ayurvedic interventions in reducing disease activity and improving symptoms in early RA, though controlled studies are needed for validation.