3,500-Year-Old Skeleton of a Woman With Rheumatoid Arthritis Discovered in Aswan, Oldest Known Case in Ancient Egypt

While exploring the necropolis of Sheikh Muhammad in Aswan, Egypt, for the Aswan-Kom Ombo Archaeological Project, a team of Italian and Polish researchers made a significant discovery. In one of the ancient tombs, they found the skeleton of a young woman who displayed clear signs of an inflammatory disease.

First Case of Autoimmune Disease

The remains were discovered in 2018 while scientists were excavating at a cemetery along the Nile river bank near Aswan in southern Egypt. Their findings were described in a study entitled "A case of rheumatoid arthritis in a Nubian woman from the site of Sheikh Mohamed, near Aswan, Egypt."

It was suggested that the Nubian woman would have stood around 5 feet (1.5 feet) tall. It was also revealed that she lived between 1750 and 1550 B.C. and could be around 25 to 30 years old when she died.

In most archaeological cases, experts do not get the full skeleton, but this woman's remains were well preserved and contained most of its bones, including its hands and feet. According to University of Toronto Department of Anthropology assistant professor Madeleine Mant, this gave the scientists a chance to conduct a thorough osteological analysis of the bones.

After investigating the woman's extremities, it was discovered that she likely had rheumatoid arthritis, a disorder that actively attacks the small bones of the hands and feet. This could be one of the earliest known cases of rheumatoid arthritis in the world.

Using the current technology, doctors diagnose the autoimmune condition using a combination of bone imaging and blood tests. They searched for proteins related to inflammation and for antibodies trained to attack the tissues of the body. In this case, the experts could only look at the bones.

In many other types of arthritis, evidence of destruction can be observed when the two bones meet, but in the case of the Nubian woman, the joint surfaces were not damaged. Instead, the experts found cavitations with smoothed-out holes. These erosive lesions in the woman's bones point to a rheumatoid arthritis diagnosis.

The earliest clinically described cases of rheumatoid arthritis did not occur until thousands of years later in 17th-century Europe. During this time, the inflammatory disease was not mentioned in ancient Egyptian texts. Other cases of rheumatoid arthritis in the archeological record include 5,500-year-old bones from ancient Egypt and 5,000-year-old skeletal remains from Alabama.

The research team noted that it is hard to know the impact the disease had on the woman's day-to-day life. However, they believe that she probably experienced a decreased quality of life, especially as her condition progressed.

What is Rheumatoid Arthritis?

Rheumatoid arthritis is an autoimmune and inflammatory disorder where the immune system mistakenly attacks the body's healthy cells. This results in inflammation in the affected parts, especially in the joints. The damaged tissue can lead to long-lasting or chronic pain, lack of balance, and deformity.

The specific causes of rheumatoid arthritis are unknown, although some factors can increase the risk of developing the disease. According to a 2023 study, less than 1% of the adult global population has a rheumatoid arthritis diagnosis.

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