By Karina Lichtenstein
Reviewed by William C. Shiel Jr., MD, FACP, FACR
Rheumatoid arthritis is an autoimmune condition in which the immune systems of affected individuals attack and destroy their own joint tissue. Untreated rheumatoid arthritis is associated with significant morbidity and mortality. Many patients with RA are untreated because they do not know they have the condition or they fail to seek treatment.
Untreated rheumatoid arthritis can have serious consequences. Avoid these seven potential complications by diagnosing and treating rheumatoid arthritis early and monitoring with your doctor regularly!
- Joint destruction and deformity: In rheumatoid arthritis, the body's immune system attacks the joint lining (synovium), leading to cartilage and bone damage. If untreated, chronic joint inflammation can lead to permanent joint damage and deformity. The best way to prevent deformities of the hands, fingers, feet, and toes is treatment early in the disease.
- Loss of function and disability: Rheumatoid joint inflammation affects tissues surrounding the joint, including tendons, ligaments, and muscles that stabilize joints. This weakens the joints and can lead to a loss of function and disability.
- Osteoporosis: People who have rheumatoid arthritis are at increased risk for the bone-thinning condition osteoporosis. Bone loss associated with the inflammation of rheumatoid arthritis is one cause for this increased risk. Joint damage and disability may also contribute to inactivity, which increases the risk of osteoporosis. Moreover, corticosteroids that are used to treat rheumatoid inflammation can also promote bone loss.
- Coronary artery disease: People who have rheumatoid arthritis have an increased risk of coronary artery disease (hardening of the arteries to the heart) compared to those who don't have rheumatoid arthritis. Inflammation is associated with both rheumatoid arthritis and coronary artery disease. Researchers suspect that inflammation related to rheumatoid arthritis triggers the buildup of plaque in the arteries.
- Anemia: Many people who have rheumatoid arthritis may also have anemia, a condition in which the body lacks enough red blood cells. Red blood cells are needed to deliver oxygen to the body tissues. Anemia often causes fatigue and other symptoms. The inflammation of chronic rheumatoid arthritis decreases the formation of red blood cells in the bone marrow, which leads to anemia.
- Early death: Untreated rheumatoid arthritis increases the risk of mortality. People who have untreated rheumatoid arthritis are twice as likely to die compared to age-matched controls who do not have the disease. At least 25% of people with RA die from cardiovascular disease, and another 25% die from infections.
- Depression and nervous system: People with RA commonly develop depression. Changes in behavior, cognitive dysfunction, problems with peripheral nerves, and spinal cord compression may also occur. The inflammatory process of RA affects the brain and nerves, which leads to neuropsychiatric symptoms.
As the exact cause of rheumatoid arthritis is unknown, it is not yet known how to prevent the disease. Ongoing studies examining the potential contribution of obesity, smoking, gut microbiome (collection of microorganisms) alterations, periodontal disease, and other factors may lead to rheumatoid arthritis prevention strategies in the future.
Rheumatoid arthritis is a serious condition, but it is manageable! Seek treatment early to give yourself the best chance at a successful outcome.
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Joaquim, A.F. and S. Appenzeller. "Neuropsychiatric Manifestations in Rheumatoid Arthritis." Autoimmunity Reviews July 31, 2015.
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"What People With Rheumatoid Arthritis Need to Know About Osteoporosis." NIH Osteoporosis and Related Bone Diseases National Resource Center. Jan. 2011.