By Dr Ananya Mandal, MD
Rheumatoid arthritis (RA) is a crippling disease associated with several complications and comorbidities or associated diseases. Some of the complications and comorbidities seen among patients with rheumatoid arthritis include:-
Inflammation of other organs
Several organs may be affected in rheumatoid arthritis along with joints.
Some patients may develop inflammation of the lining covering the lungs. This is called pleurisy. Pleurisy leads to chest pain especially while breathing.
Inflammation may also affect the heart muscles and the lining of the heart called the pericardium. The latter condition is called pericarditis. This leads to moderate to severe chest pain.
Blood vessels may also be inflamed in a condition known as vasculitis. In this condition the blood vessel walls are weakened and thickened leading to narrowing and scarring and obstructed blood flow. Several major organs are thus deprived of adequate blood supply.
Eyes may be affected with inflammation in patients of rheumatoid arthritis. The condition is termed Sjogren’s syndrome that leads to dry eyes, lack of tears secretion and dry mouth. The whites of the eyes may be affected with inflammation causing scleritis.
Carpal tunnel syndrome
Excessive pressure over the major nerve (median nerve) in the wrist may lead to numbness, tingling, pain and difficulty in movement of the fingers and hand. Carpal tunnel syndrome may be seen with or without rheumatoid arthritis but is common in these patients due to deformities and changes in the tendons and ligaments due to inflammation.
Tendon changes and rupture
Tendons are tissues that connect muscles to bones. Rheumatoid arthritis leads to inflammation over these structures and this may lead to formation of inflamed spots, swellings and even rupture. The tendons in the backs of the fingers are most commonly affected.
This is caused by dislocation of the joints of the vertebrae at the neck. This can seriously hamper mobility.
Raised risks of death
Those with rheumatoid arthritis are more at risk of an early death than those without. These individuals often suffer from complications like cardiovascular disease and infection that raise their risk of dying early. These individuals have a higher risk of heart attacks and strokes. This could be due to inflammation of the blood vessels.
Raised risk of lymphomas and cancers
There is a slightly elevated risk of lymphomas and lymphoid cancers among those with rheumatoid arthritis. The risk of melanotic and non-melanotic skin cancers is also raised.
Treatment associated disorders
There may be several treatment associated disorders. These include gastric ulcers and kidney damage due to prolonged usage of non steroidal anti inflammatory drugs (NSAIDs), risk of osteoporosis and cataract due to steroid use and risks of infections and melanoma due to use of biological agents and steroids.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)