Rheumatoid Arthritis (RA) Complications

When you think of rheumatoid arthritis, or RA, you might think of stiff, painful joints. But you may not know that complications can occur in other parts of your body.

The same process that hurts your joints can also cause problems for your eyes, lungs, skin, heart, blood vessels, and other organs.

And, the medications you take for RA can also have side effects.

You can manage the complications of rheumatoid arthritis. Just make sure to pay attention to problems early and get the right treatment.

Effects on the Skin

You might develop lumps of tissue called rheumatoid nodules. They usually appear on your skin, especially on the elbows, forearms, heels, or fingers. They can appear suddenly, or grow slowly. The nodules may be a sign your rheumatoid arthritis is getting worse. They can also form in other areas of the body like the lungs and heart.

There’s also something called vasculitis, which is rheumatoid arthritis-related inflammation of the blood vessels. It shows up as spots on the skin that look like ulcers.

Other types of skin problems related to RA may appear, so always let your doctor know about anything new that pops up or breaks out.

Eye Complications

Rheumatoid arthritis can affect the eyes in several ways. Inflammation of the episclera, a thin membrane that covers the white of your eye, is common. It’s usually mild, but the eye may get red and painful. Scleritis, an inflammation of the white of the eye, is more serious and can lead to vision loss.

RA also puts you at risk for Sjogren's syndrome. This happens when your immune system attacks the glands that produce tears. It can make your eyes feel gritty and dry. If it’s not treated, the dryness can cause infection and scarring of the conjunctiva, which is the membrane that covers the eye, and the cornea.

Pain in the Neck

Rheumatoid arthritis is known to cause pain in the joints of the fingers and wrists. But it can also affect other parts of your body, like your neck. If your neck feels stiff and you have pain when you turn your head, it could be your rheumatoid arthritis.

Some simple exercises might help. Talk to your doctor about the best exercises and treatments to help relieve your neck pain.

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Heart and Blood Vessel Disease

Pericarditis, or inflammation of the membrane that surrounds your heart, usually develops during flares. Flares are times when your RA is worse.

If it happens a lot, pericarditis can cause the membrane to thicken and tighten. That can interfere with your heart's ability to work properly.

Rheumatoid nodules can also form on the heart and affect the way it functions.

Inflammation of the heart muscle itself, called myocarditis, is a rare complication, but sometimes happens.

Rheumatoid arthritis can put you at increased risk of cardiovascular disease. It also increases your risk of stroke.

Blood Disease

Rheumatoid arthritis can cause a reduction in red blood cells. This is called anemia. Anemia may cause fatigue, rapid heartbeat, shortness of breath, dizziness, leg cramps, and insomnia, or sleeplessness.

Thrombocytosis is another complication from RA. This happens when inflammation leads to high levels of platelets in your blood. Platelets help your blood clot in order to stop bleeding, but too many can lead to conditions including stroke, heart attack, or clots in your blood vessels.

An unusual complication with rheumatoid arthritis is Felty's syndrome. This is when your spleen is enlarged and your white blood cell count is low. It can increase your risk of lymphoma, a cancer of the lymph glands.

Lung Problems

Rheumatoid arthritis can cause inflammation in your lungs, which can lead to pleuritis (pleurisy), a condition that makes breathing painful.

Rheumatoid nodules can form in your lungs too. Usually, they’re harmless, but can lead to problems such as a collapsed lung, coughing up blood, infection, or pleural effusion, which is fluid build-up between the lining of your lung and your chest cavity.

Interstitial lung diseases, which involve scarring of the lung tissue and pulmonary hypertension, a type of high blood pressure that damages arteries in the lung and heart, can also develop as complications from RA.

Infections

It’s possible you may get more infections if you have rheumatoid arthritis. This could be from the condition itself or the immune-suppressing medicine that treats it.

Emotional Effects

Living every day with the pain of a chronic condition can take a toll. One recent study showed that almost 11% of people with rheumatoid arthritis had symptoms of depression. The more severe the RA, the more depression the participants felt.

If you have rheumatoid arthritis and feel anxious or depressed, discuss it with your doctor. There are many things he can offer that will help you feel better.

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Protect Yourself from RA Complications

You may not think to mention problems like depression, chest pain, or dry eyes to the doctor who treats your rheumatoid arthritis, but you should. All these problems can be related to it.

You might need different doctors and different treatments to control your RA and to take care of any new problems that come up. Always discuss new symptoms with your doctor.

WebMD Medical Reference Reviewed by David Zelman, MD on August 25, 2016

Sources

SOURCES:

Anderson R. Primer on the Rheumatic Diseases, ed. 12, 2001.

Dickens C. Psychosomatics, May-June 2003.

Maradit-Kremers, H. Arthritis & Rheumatism, February 2005.

American College of Rheumatology Annual Scientific Meeting, 2008.

Johns Hopkins Vasculitis Center: "Rheumatoid Vasculitis Information."

University of California, San Francisco: "Rheumatoid Arthritis and the Lung."

Arthritis Foundation: "Infection Risk with Anti-TNF Therapy," "Depression in People with RA," "Rheumatoid Arthritis: What Are the Effects?"

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