World Autoimmune Arthritis Day is celebrated every year on May 20 to raise awareness and spread awareness about the different types of autoimmune arthritis. Rheumatoid arthritis (RA) is a type of autoimmune arthritis in which the body’s immune system attacks its own tissues, including the joints. Symptoms of arthritis include fever, swollen lymph nodes, loss of hand function, difficulty in walking, and sleep disturbance. Rheumatoid arthritis not only affects your joints, but also puts you at risk for heart disease, high blood pressure, fatty liver, lung disease and cancer. (Also read: World Autoimmune Arthritis Day 2023: Date, History, Significance and Celebration)
Arthritis and its different types
“Arthritis is a condition characterized by joint inflammation, a serious health problem that causes severe pain and stiffness in individuals. It encompasses a wide range of disorders affecting the joints, surrounding tissues and connective tissue. There are over 160 different types. Arthritis , which can be triggered by a variety of factors such as medications, autoimmune reactions, infections, trauma, crystals, or malignancies. The most common forms include osteoarthritis (OA) and rheumatoid arthritis (RA), with RA being an autoimmune disorder that predominantly affects women. 30 to the age of 60. In India alone, about 1 in 100 people are affected by rheumatoid arthritis,” says Dr Preet Pal Thakur, co-founder of Glamio Health.
What is Rheumatoid Arthritis?
Rheumatoid Arthritis is an autoimmune and inflammatory disease in which a person’s immune system attacks the body’s own healthy cells causing joint pain, swelling in the affected joints in the body leading to restricted activities and joint deformity. It usually attacks the joints of hands, wrists, elbows, feet etc. Due to chronic inflammation, the lining of the joint becomes inflamed, which damages the joint tissues. This causes chronic or chronic pain, restricted activity and joint deformity. If the disease is left untreated, it can affect other tissues in the body, leading to systemic complications such as interstitial lung disease, bone marrow, cardiovascular involvement, cardiomyopathy and pericarditis, says Dr Santosh Kumar Aggarwal, Senior Consultant Physician, Internal Medicine. Medicine, Marengo Asia Hospital Faridabad.
Many complications of rheumatoid arthritis
“Rheumatoid arthritis (RA) is not only a disease that affects the joints but also affects various other aspects of the patient’s health. An important concern is the increased risk of cardiovascular disease (CVD) in people with RA. Many studies have shown higher. than in the general population. Prevalence of CVD in RA patients. The chronic inflammation characteristic of RA plays an important role in this high risk. It contributes to endothelial dysfunction, accelerates the development of atherosclerosis, and increases the risk of cardiovascular events such as heart attacks and strokes,” Dr. Sandeep Surendran, Consultant, Rheumatology and Clinical Immunology, Amrita Hospital, Kochi says.
“In addition, traditional risk factors for CVD, including hypertension, dyslipidemia, obesity, and smoking, are often more prevalent in RA patients. To effectively address the increased risk of CVD in RA patients, it is important to prioritize early detection and aggressive management. These traditional risk factors factors. Proper control of RA inflammation is also paramount. This requires integrated care and collaboration between rheumatologists and cardiologists to ensure comprehensive management and improved outcomes for RA patients,” adds Dr Sandeep.
Malignancies caused by rheumatoid arthritis
Dr. Sandeep says people with rheumatoid arthritis are at risk of:
1. Knee replacement in osteoarthritis and rheumatoid arthritis
RA increases the risk of osteoarthritis and the need for knee replacement surgery. Chronic inflammation in RA leads to joint damage and cartilage loss, making individuals more susceptible to secondary osteoarthritis. Studies have found a higher prevalence of knee osteoarthritis in RA patients than in the general population. The aggressive nature of RA can lead to further joint destruction, eventually requiring knee replacement surgery. However, early and effective management of RA is critical to controlling inflammation and reducing the risk of secondary osteoarthritis, potentially reducing the need for knee replacement.
2. Fatty liver disease
In addition to joint-related complications, RA is associated with an increased risk of fatty liver disease. Chronic inflammation in RA can lead to metabolic abnormalities, including insulin resistance and dyslipidaemia, which contribute to the development of non-alcoholic fatty liver disease (NAFLD). Studies have shown a higher prevalence of NAFLD in RA patients than in the general population. Furthermore, some medications commonly used to manage RA, such as corticosteroids and methotrexate, may further increase the risk of fatty liver. Regular monitoring of liver function and adoption of lifestyle modifications, such as weight management and healthy dietary habits, are important to reduce the risk and progression of fatty liver disease in RA patients.
Another concerning aspect of RA is its association with an increased risk of certain types of cancer. Chronic inflammation associated with RA may contribute to cancer development and progression. Studies have indicated a higher risk of lymphoma, especially non-Hodgkin’s lymphoma, in people with RA. In addition, RA patients may be more prone to lung, skin, and gastrointestinal cancers. The use of immunosuppressive drugs, including methotrexate and biologic agents commonly prescribed for RA, may also contribute to overall cancer risk. To reduce this risk, regular cancer screening, vigilant surveillance, and appropriate management of RA inflammation are important for early detection and treatment of potential malignancies in RA patients.
RA patients also face an increased risk of stroke. The chronic inflammation characteristic of RA can lead to vascular dysfunction, accelerate the progression of atherosclerosis, and increase the likelihood of cardiovascular events, including stroke. To reduce the incidence of stroke in RA patients, effective control of RA inflammation is essential. In addition, managing traditional stroke risk factors such as hypertension, dyslipidemia, diabetes, and smoking cessation are important to reduce overall risk.
Dr Akhilesh Yadav, Associate Director – Orthopedics & Joint Replacement, Max Hospital Vaishali adds more diseases to the list.
5. Heart disease
People with RA have an increased risk of developing cardiovascular disease (CVD). In India, CVD is the leading cause of death. Inflammation caused by rheumatoid arthritis can damage blood vessels and lead to the development of CVD. People with rheumatoid arthritis should monitor their blood pressure, cholesterol levels, and blood sugar levels to reduce their risk of developing heart disease.
People with rheumatoid arthritis have a weakened immune system, which makes them more susceptible to certain infections. Infectious diseases such as tuberculosis (TB) and hepatitis B and C are rampant in India. People with rheumatoid arthritis should take steps to prevent infection by practicing good hygiene and getting vaccinated against infectious diseases.
Dr. Santosh Kumar Aggarwal, Senior Consultant Physician, Internal Medicine, Marengo Asia Hospital Faridabad shares more diseases that can be caused by rheumatoid arthritis.
7. Felty syndrome
This is an uncommon complication caused by rheumatoid arthritis. This happens when your spleen is enlarged and your white blood cell count is low. It can increase the risk of lymphoma.
8. Lung problems
Rheumatoid arthritis can cause inflammation in your lungs. This can lead to pleuritis (pleurisy), a condition that makes breathing difficult. Rheumatoid nodules can also develop in your lungs, which can cause problems like a collapsed lung, coughing up blood, infection or pleural effusion, which is fluid that builds up between the lining of your lungs and the chest cavity. Due to rheumatoid arthritis, interstitial lung diseases can develop. These lung diseases cause scarring of the lung tissue and pulmonary hypertension, a type of high blood pressure that severely damages the arteries in the lungs and heart.