8 Complications of Rheumatoid Arthritis


Chris Iliades, MD

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If you have been diagnosed with rheumatoid arthritis (RA), you know the common symptoms: joint pain, fatigue, and morning stiffness. You also need to be aware of RA complications. Complications, also called extra-articular disease, are conditions caused by RA that affect areas of your body besides your joints.

You are more likely to have complications if you have severe RA. Although RA is more common in women, men are at greater risk of RA complications. Knowing about the possible complications and their symptoms can help you and your doctor catch these problems early.

Here are some of the most common complications to watch for:

  1. Skin. About 20 percent to 30 percent of people with RA get hard bumps that form under the skin. These bumps are called rheumatoid nodules. They are most likely to develop on areas where you put a lot of pressure, such as your knees and elbows. RA is also known to cause rashes, ulcers, and blisters on your skin.

  2. Lung. RA lung disease can make it hard for you to breathe. You can experience pleurisy, which is swelling of the moist tissue layer that covers your lungs. RA is known to cause fluid to form around your lungs. It can also lead to nodules inside your lungs and changes in your lung tissue. This is called fibrosis. In addition, recent studies indicate that chronic obstructive pulmonary disease (COPD) is more common in people with RA.

  3. Heart. Heart complications can cause chest pain or difficulty breathing. The lining around your heart can swell and collect fluid. This condition is called pericarditis. RA is also known to cause nodules to grow inside your heart. This may increase your risk for coronary heart disease.

  4. Sjogren's (pronounced "show-grenz") syndrome. This complication affects 10 percent to 15 percent of people with RA. In Sjogren's syndrome, inflammation overwhelms the  tear glands and the salivary glands in your mouth. This causes tissue swelling and reduced tears and saliva. If you have Sjogren's syndrome you may have a very dry mouth and dry, red, painful eyes.

  5. Eyes. Sjogren's syndrome is the most common RA-related eye complication. In addition, RA can cause scleritis. This is inflammation of the outer part of your eye. Inflammation can cause an ulcer to form on the outer lining of your eye. You may have eye dryness, redness and pain.

  6. Blood vessels. RA can cause swelling of small blood vessels, called vasculitis. Vasculitis decreases the blood supply to parts of your body. The most common sign of vasculitis is black areas of dying tissue under your fingernails. These are called digital infarcts. Vasculitis that affects the nerves of your hands and feet can cause numbness, burning, and tingling.

  7. Osteoporosis. Osteoporosis is a thinning and weakening of your bones. The first symptom could be a broken bone. It is most common in women with RA after menopause. Men with RA who are older than 60 years are also at risk. Osteoporosis is more frequent with RA if your activity is limited by pain and stiffness. Your doctor can check for osteoporosis by doing a bone density test.

  8. Depression. One final complication to watch out for is depression. Having a long-lasting, unpredictable disease such as RA adds a lot of stress to your life. Stress makes you more likely to suffer from depression. Most people who experience depression don't tell their RA doctor about it, but talking can help. Let your doctor know if you are not enjoying life the way you used to in the past. There are many self-help and medication therapies for depression.

Studies show that people with RA who learn as much as they can about their disease and work closely with their doctors have a better quality of life. Know what to look for and let your doctor know right away if you suspect any RA complications.

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