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Symptoms and Complications of Rheumatoid Arthritis (RA)

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Overview
Cardiac
Eyes
Fatigue
Joints
—Bone Density
—Swan Neck Deformity
Neuropathy
Psychological
Pulmonary
Renal
Vascular
Complications

Overview

Abstract painting of mist in the catskills by Janet PaulmennAlthough rheumatoid arthritis is often thought of as a disease that affects only the joints, it is actually a systemic disease, which means that it can affect nearly any part of the body.

Common symptoms include fatigue, weakness, muscle pain, reduced appetitie as well as heart, kidney, lung, and vascular problems.

Symptoms of Rheumatoid Arthritis. The disease usually begins gradually with fatigue, morning stiffness (lasting more than one hour), widespread muscle aches, loss of appetite, and weakness. Eventually, joint pain appears. When the joint is not used for a while, it can become warm, tender, stiff, and swollen. Joint pain is often felt on both sides of the body, and may effect the wrist, knees, elbows, fingers, toes, ankle or neck. Medline Plus.

Are foot and ankle characteristics associated with falls in people with rheumatoid arthritis (RA)? A prospective study. Foot and ankle characteristics are not associated with falls in people with RA and enquiries about prior falls and psychotropic medications may assist in identifying patients with RA who are at high risk of future falls. PubMed, Arthritis Care Res (Hoboken), 10/21/2016.

Is articular pain in rheumatoid arthritis (RA) correlated with ultrasound power Doppler (PD) findings? Intra-articular PD was not correlated with pain symptoms patients with RA. PubMed, Clin Rheumatol, 05/09/2015.

Depression and pain in patients with rheumatoid arthritis (RA): Mediating role of illness perception. Targeting illness perceptions in adults with RA and depression may help reduce pain symptoms. ScienceDirect, The Egyptian Rheumatologist, April 2014. (Also see Depression)

Cardiac Involvement

Heart Disease and Rheumatoid Arthritis. Rheumatoid arthritis almost doubles the risk of having a heart attack within the first 10 years of getting an RA diagnosis. WebMD.

Association between leptin and IL-6 concentrations with cardiovascular risk (CVR) in patients with rheumatoid arthritis. There is a positive association between CVR and serum leptin concentrations and it is also significantly associated with traditional and non–traditional risk factors. PubMed, Clin Rheumatol, 11/03/2017.

Impact of disease activity and treatment of comorbidities on the risk of myocardial infarction (MI) in rheumatoid arthritis. C–reactive protein (CRP) was associated with risk of MI and the results underline the importance of tight disease control taking not only global disease activity, but also CRP as an individual marker into account. Bio Med Central, Arthritis Research & Therapy, 08/05/2016. (Also see DMARDs)

Clinical profile and outcome of patients with rheumatoid arthritis (RA) and abnormally high aortic stiffness (AoSI). Increased AoSI is common, can be predicted by an ordinary clinical assessment and is a strong predictor of adverse clinical outcome at mid–term follow–up in patients with RA. Sage Journals, European Journal of Preventive Cardiology, 05/10/2016.

Cardiovascular (CV) risk in rheumatoid arthritis (RA): assessment, management and next steps. Tight control of disease activity, management of traditional risk factors and lifestyle modification represent, amongst others, the most important steps in improving CV disease outcomes in RA patients. Sage Journals, Therapeutic Advances in Musculoskeletal Disease, 05/10/2016.

Arterial stiffness (AS) is associated with left ventricular (LV) dysfunction in patients with rheumatoid arthritis (RA). The aim of the study was to evaluate the impact of AS on LV functions in patients with rheumatoid arthritis. Springer Link, 01/07/2016.

Coronary(CAC) and Abdominal Aorta Calcification (AAC) in Rheumatoid Arthritis (RA): Relationships with Traditional Cardiovascular Risk Factors, Disease Characteristics, and Concomitant Treatments. In patients with RA, CAC and AAC are more prevalent and more severe compared with age–matched and sex–matched control participants. Current use of methotrexate is a major determinant of the absence of CAC, and erosive arthritis is a major determinant of AAC. PubMed, J Rheumatol, 2014 Oct 1.

Eye Involvement

Can rheumatoid arthritis affect the eyes? Eye conditions associated with rheumatoid arthritis may include dry eyes, uveitis, scleritis, glaucoma and cataracts. Mayo Clinic.

Fatigue

Explanatory factors and predictors of fatigue in persons with rheumatoid arthritis: A longitudinal study. Pain threshold and depressive mood were the most important factors for fatigue in persons with rheumatoid arthritis. PubMed, J Rehabil Med, 2016 Apr 28;48(5):469-76.

Joints

Bone Density

Serum serotonin levels and bone in rheumatoid arthritis (RA) patients. Our data reinforce a role, despite weak, for circulating serotonin in regulating bone mass in RA patients, with some differences in terms of gender and anatomical sites. PubMed, Rheumatol Int, 10/09/2017.

There is still a care gap in osteoporosis management for patients with rheumatoid arthritis. Although compliance with current osteoporosis guidelines remains low among all patients with rheumatoid arthritis, higher risk patients were more likely to have a bone mineral density test and receive treatment for osteoporosis. PubMed, Joint Bone Spine, 2014 Apr 2. (Also see Osteoporosis)

Swan Neck Deformity

Drawing of Swan Neck Deformity. Netter Images.

Swan-neck deformity is a bending in (flexion) of the base of the finger, a straightening out (extension) of the middle joint, and a bending in (flexion) of the outermost joint. Merck Manuals.

Structural deterioration of finger joints with ultrasonographic synovitis in rheumatoid arthritis patients with clinical low disease activity (CLDA). Even in patients with a long period of CLDA, finger joints with positive synovial vascularity showed structural alteration, especially in the progression of joint space narrowing. PubMed, Rheumatology (Oxford), 2014 Apr 4.

Neuropathy

Neuropathy Causes And Treatments. Autoimmune diseases such as lupus and rheumatoid arthritis also increase one's chance of developing a neuropathy. Medical News Today.

Association between serum vitamin D levels and neuropathic pain (NP) in rheumatoid arthritis (RA) patients: A cross–sectional study. Although further research is needed to clarify the association between serum vitamin D levels and NP, our study raises awareness of the need to screen for vitamin D deficiency in RA patients with NP. PubMed, Int J Rheum Dis, 08/31/2017. (Also see Vitamin D Deficiency)

Psychological Factors

Discrepancy between subjective and objective measures of cognitive impairment in patients with rheumatoid arthritis. The findings emphasize the gap between subjective and objective measures of cognitive impairment and the importance of considering psychological factors within the context of cognitive complaints in clinical settings. PubMed, Rheumatol Int, 09/04/2017.

Immune responses to stress in rheumatoid arthritis (RA) and psoriasis. Patients with RA have a different immune response to stress than patients with psoriasis or healthy controls. More needs to be learned about the complex interaction between stress, immune parameters and chronic inflammation. PubMed, Rheumatology (Oxford), 2014 May 20. (Also see Psoriasis, and Stress)

Pulmonary (Lung) Involvement

People with arthritis are nearly 50% more likely to develop a deadly lung disease, researchers warn. People living with arthritis are at greater risk of a deadly lung disease; it has been added by experts to the list of complications, along with heart disease and diabetes, now linked to the painful condition. Mail Online, 10/20/2017.

Renal (Kidney) Involvement

Prevalence, incidence and prognosis of chronic kidney disease (CKD) classified according to current guidelines: a large retrospective cohort study of rheumatoid arthritis (RA) patients. The incidence of CKD increases over time among RA patients and prevalent CKD may be an insidious risk factor linked to increased mortality in RA patients. PubMed, Nephrol Dial Transplant, 2017 Dec 1;32(12):2035-2042.

Risk of incident liver disease in patients with psoriasis (PsO), psoriatic arthritis (PsA) and rheumatoid arthritis (RA): a population–based study. More so than RA, PsO and PsA are associated with liver disease, particularly non-alcoholic fatty liver disease and cirrhosis, and this was true even among patients without systemic therapy exposure. PubMed, J Invest Dermatol, 10/27/2017. (Also see Psoriasis and Psoriatic Arthritis)

End Stage Renal Disease (ESRD) in Patients with Rheumatoid Arthritis. Physicians should be aware of the critical impact of the comorbidities of diabetes and hypertension in causing ESRD in RA patients. Seminars in Arthritis and Rheumatism, 07/16/2016.

Swan Neck Deformity

Swan Neck Deformity is a classic feature of rheumatoid arthritis that is related to laxity and instability of the joint as the rheumatoid lesion destroys the supporting tissues. It is almost never seen in systemic scleroderma (SSc) unless it is in overlap with rheumatoid arthritis (RA).

Vascular Involvement

Acute effect of a resistance exercise (RE) session on markers of cartilage breakdown and inflammation in women with rheumatoid arthritis (RA). Women with and without RA have similar changes in response to a RE session in levels of inflammation biomarkers, but not of cartilage breakdown. PubMed, Int J Rheum Dis, 11/03/2017.

Vascular calcifications on hand radiographs in rheumatoid arthritis (RA) and associations with autoantibodies, cardiovascular risk factors and mortality. Vascular calcifications on hand radiographs were independently associated with increased all-cause mortality in RA. PubMed, Rheumatology (Oxford), 04/07/2015.

Rheumatoid vasculitis: an update. Rheumatoid vasculitis remains a rare yet challenging extra-articular manifestation of rheumatoid arthritis with high morbidity and mortality, despite aggressive use of disease-modifying therapy. PubMed, Curr Opin Rheumatol, 2015 Jan;27(1):63-70.

Complications Due to Rheumatoid Arthritis

miR-210 expression in PBMCs from patients with systemic lupus erythematosus and rheumatoid arthritis. The dysregulation of miR-210 levels in SLE and RA patients suggests that miR-210 might play an important role in the pathogenesis of these diseases. PubMed, Ir J Med Sci, 05/30/2017. (Also see Lupus Research)

Case Report: Antiphospholipid syndrome (APS) in a patient with rheumatoid arthritis (RA). We report a case of APS manifesting as cutaneous ulceration and necrosis in a patient with severe RA. PubMed, Cutis. (Also see Antiphospholipid Syndrome)

Occasional presence of herpes viruses in synovial fluid and blood from patients with rheumatoid arthritis and axial spondyloarthritis. Results indicate the occasional presence of DNA from herpes viruses in patients with rheumatoid arthritis or with axial spondyloarthritis. PubMed, Clinical Rheumatology, 05/20/2015. (Also see Ankylosing Spondylitis)

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