Rheumatoid Arthritis (cont.)
How Does Rheumatoid Arthritis Affect the Entire Body?
- Musculoskeletal structures: Damage to muscles surrounding joints may cause atrophy (shrinking) that results in weakness. This is most common in the hands. Atrophy also may result from not using a muscle, such as from pain or swelling. Damage to bones and tendons can cause deformities, especially of the hands and feet. Osteoporosis and carpal tunnel syndrome are other common complications of rheumatoid arthritis.
- Skin: Many people with rheumatoid arthritis develop small, firm nodules on or near the joint that are visible under the skin. These are known as rheumatoid nodules and are most noticeable under the skin on the bony areas that stick out when a joint is flexed. Dark purplish areas on the skin (purpura) are caused by bleeding into the skin from weakened blood vessels. Purpura is particularly common in those patients who have taken cortisone medication, such as prednisone.
- Heart: A collection of fluid around the heart (pericardial effusion) from inflammation is not uncommon in rheumatoid arthritis. This usually causes only mild symptoms, if any, but it can be very severe and lead to poor heart function. Rheumatoid arthritis-related inflammation can affect the heart muscle, the heart valves, or the blood vessels of the heart (coronary arteries). Heart attacks are more frequent in patients with rheumatoid arthritis than those without it, therefore, monitoring cholesterol and cardiovascular health is important.
- Lungs: Rheumatoid arthritis' effects on the lungs may take several forms. Fluid may collect around one or both lungs and is referred to as a pleural effusion. Inflammation of the lining tissues of the lungs is known as pleuritis. Less frequently, lung tissues may become stiff or scarred, referred to as pulmonary fibrosis. Any of these effects can have a negative effect on breathing. Lung infections are more common with rheumatoid arthritis. Rheumatoid nodules of local inflammation can occur in the lungs.
- Digestive tract: The digestive tract is usually not affected directly by rheumatoid arthritis. Dry mouth, related to Sjögren's syndrome, is the most common symptom of gastrointestinal involvement. Digestive complications are much more likely to be caused by medications used to treat the condition, such as gastritis (stomach inflammation) or stomach ulcer caused by NSAID therapy.
- Kidneys: The kidneys are not usually affected directly by rheumatoid arthritis. Kidney problems in rheumatoid arthritis are much more likely to be caused by medications used to treat the condition. Nevertheless, severe, long-standing disease can uncommonly lead to a form of protein deposition and damage to the kidney, referred to as amyloidosis.
- Blood vessels: Inflammation of the blood vessels can cause problems in any organ but is most common in the skin, where it appears as purple patches (purpura) or skin ulcers.
- Blood: Anemia or "low blood" is a common complication of rheumatoid arthritis. Anemia means that there is an abnormally low number of red blood cells and that these cells are low in hemoglobin, the substance that carries oxygen through the body. (Anemia has many different causes and is by no means unique to rheumatoid arthritis.) A low white blood cell count (leukopenia) can occur from Felty's syndrome, a complication of rheumatoid arthritis that is also characterized by enlargement of the spleen.
- Nervous system: The deformity and damage to joints in rheumatoid arthritis often lead to entrapment of nerves. Carpal tunnel syndrome is one example of this. Entrapment can damage nerves and may lead to serious consequences.
- Eyes: The eyes commonly become dry and/or inflamed in rheumatoid arthritis. This is a result of inflammation of the tear glands and is called Sjögren's syndrome. The severity of this condition depends on which parts of the eye are affected. There are many other eye complications of rheumatoid arthritis, including inflammation of the whites of the eyes (scleritis), that often require the care of an ophthalmologist.
Like many autoimmune diseases, rheumatoid arthritis typically waxes and wanes. Most people with rheumatoid arthritis experience periods when their symptoms worsen (known as flares or active disease) separated by periods in which the symptoms improve. With successful treatment, symptoms may even go away completely (remission, or inactive disease).
What Are Causes and Risk Factors of Rheumatoid Arthritis?
The cause of rheumatoid arthritis is not known. Many risk factors are involved in the abnormal activity of the immune system that characterizes rheumatoid arthritis. These risk factors include genetics (inherited genes), hormones (explaining why the disease is more common in women than men), and possibly infection by a bacterium or virus. Other environmental factors known to increase the risk for developing rheumatoid arthritis include tobacco smoking, silica exposure, and periodontal (gum) disease. Medical scientists suspect that gut bacteria (those that normally inhabit the bowels) could be triggers for the onset of rheumatoid arthritis. This remains to be proven. This may explain why some individuals with rheumatoid arthritis feel better with various dietary modifications.
Medically Reviewed by a Doctor on 11/17/2015
Must Read Articles Related to Rheumatoid Arthritis
Arthritis is inflammation of the joints. Causes include injury, abnormal metabolism (such as gout), inheritance (such as in osteoarthritis), infections (such as...learn more >>
Chronic pain is pain that persists for a period of six months or longer, and is the result of a long-standing medical condition(s) or damage to the body. Common...learn more >>
Iritis, or anterior uveitis, is an inflammation on the front part of the eye called the iris, which is the colored part of the eye that opens and closes the pup...learn more >>
Patient Comments & Reviews
The eMedicineHealth doctors ask about Rheumatoid Arthritis (RA):