Rheumatoid Arthritis (RA) Complications
Heart and Blood Vessel Disease continued...
Drugs used for RA treatment may also weaken the heart and other muscles.
Systemic inflammation puts people with RA at increased risk of cardiovascular disease. Recent research shows that people with RA have an increased risk of heart attack that is about the same as for people with type 2 diabetes. Having RA also increases risk of stroke.
Inflammation of blood vessels, called vasculitis, is an uncommon but serious complication of rheumatoid arthritis. Vasculitis associated with RA, called rheumatoid vasculitis, more commonly affects the small blood vessels supplying the skin, but it can affect many of the body's organs, including the eyes, heart, and nerves.
Diseases of the Blood and Blood-Forming Cells
Most people with active RA experience a reduction in red blood cells called anemia. Anemia may cause symptoms such as fatigue, rapid heart beat, shortness of breath, dizziness, leg cramps, and insomnia. Active inflammation may also lead to high levels of blood platelets, while treatment to suppress the immune system may lead to low levels of blood platelets, a condition called thrombocytopenia.
Another possible, but uncommon complication of RA is Felty's syndrome, a condition in which the spleen is enlarged and the white blood cell count is low in people with rheumatoid arthritis. Having Felty's syndrome may increase the risk of lymphoma, a cancer of the lymph glands.
The inflammatory process that affects the lining of the heart can similarly affect the membrane lining the lungs, leading to pleuritis and fluid collection.
Rheumatoid nodules also can form in the lungs. In most cases, the nodules are harmless, but can possibly lead to problems such as a collapsed lung, coughing up blood, infection, or pleural effusion -- the accumulation of fluid between the lining of the lung and the chest cavity. Interstitial lung diseases and pulmonary hypertension can also develop as complications of RA.
RA treatments can affect the lungs, as well. For example, one of the most commonly used RA treatments, methotrexate, can potentially cause lung problems, characterized by shortness of breath, cough, and fever. Symptoms tend to improve when methotrexate is stopped.
Susceptibility to Infection
People with RA are more prone to infections, which may be related to the underlying disease itself or the immune-suppressing medications used to treat it. Studies show that treatment with biologic agents, a relatively new and effective class of RA treatment, may greatly increase the risk of serious infections in people with RA.
Living day to day with the pain and limitations of a chronic disease can take a toll on your emotional as well as physical health. One recent study showed that almost 11% of people with RA had moderately severe to severe symptoms of depression. Those who were rated as being more restricted in their normal activities were significantly more likely to have depression. The study also showed that only one in five patients who showed symptoms of depression discussed it with their arthritis doctor.