Rheumatoid arthritis
Summary
Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling, stiffness and loss of function in your joints. It can affect any joint but is common in the wrist and fingers. More women than men get rheumatoid arthritis. It often starts in middle age and is most common in older people. But children and young adults can also get it. You might have the disease for only a short time, or symptoms might come and go. The severe form can last a lifetime. Rheumatoid arthritis is different from osteoarthritis, the common arthritis that often comes with older age. RA can affect body parts besides joints, such as your eyes, mouth and lungs. RA is an autoimmune disease, which means the arthritis results from your immune system attacking your body’s own tissues.
(Autoimmune Association, 2022)
Symptoms
Signs and symptoms of rheumatoid arthritis may include:
Tender, warm, swollen joints
Joint stiffness that is usually worse in the mornings and after inactivity
Fatigue, fever and loss of appetite
Early rheumatoid arthritis tends to affect your smaller joints first — particularly the joints that attach your fingers to your hands and your toes to your feet.
As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body.
About 40% of people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Areas that may be affected include:
Skin
Eyes
Lungs
Heart
Kidneys
Salivary glands
Nerve tissue
Bone marrow
Blood vessels
Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission — when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place.
(Autoimmune Association, 2022)
Diagnostic Criteria
None. (Aggarwal et al, 2015)
Study Classification Criteria
(Rheumatology.org, 2010)
Diagnostic Tests
Under Investigation
Organized Autoimmunity
(Alternative Autoimmune Disease Classification: FIEM, MIEM or BIEM, or FEM, MEM or BEM)
sex predominance (is an autoimmune disease primarily found in genetic Females, Males, or equally in Both?)
Female
Inherited and acquired gene variations that cause increased susceptibility
Human Leukocyte Antigen (HLA) Associations
Under Investigation
Other Gene Variations (mutations)
Variations (mutations) in the protein tyrosine phosphatase non-receptor type 22 (PTPN22) gene (National Institutes of Health, 2022)
Gene Triggering Environmental Exposures
Infections
COVID-19 (Metyas et. al, 2022 documented three cases of new-onset Rheumatoid arthritis 4-5 weeks after COVID-19 diagnosis) (Chang et. al, 2023, found a significantly higher risk of Rheumatoid arthritis following COVID-19 infection in a study of 3,814,479 participants)
Subdoligranulum isolate 7, an intestinal bacteria found in 16.7% of study participants with early Rheumatoid arthritis. When introduced into mice, this bacteria caused rheumatoid-like disease in the mice. (Chriswell et. al, 2022)
Toxins
Under Investigation
Stress
Needs to be assessed for each patient
Multiple interactive and destructive immune system pathologies
One study indicated that positive anti-RO and anti-LA antibodies in participants with Rheumatoid arthritis indicated polyautoimmunity (Ordoñez-Cañizares, 2022). Polyautoimmunity is when two or more autoimmune diseases that meet study classification criteria occur in one person.
Tissue-Type or Cell-Type Attacked
Under Investigation
Treatment(s)
Under Investigation
Managing Specialist(s)
Rheumatologist
Research Authors
Under Investigation
Research Institutions
Under Investigation
Average Time from Symptom Onset to Diagnosis
Under Investigation
Last Updated
September 04, 2023
References
2010 Rheumatoid Arthritis Classification. Rheumatology.org. (2010). Retrieved December 05, 2022, from https://www.rheumatology.org/Portals/0/Files/2010%20Rheumatoid%20Arthritis%20Classification_EXCERPT%202010.pdf
Aggarwal, R., Ringold, S., Khanna, D., Neogi, T., Johnson, S.R., Miller, A., Brunner, H.I., Ogawa, R., Felson, D., Ogdie, A., Aletaha, D. and Feldman, B.M. (2015), Distinctions Between Diagnostic and Classification Criteria?. Arthritis Care & Research, 67: 891-897. https://doi.org/10.1002/acr.22583
Chang R, Yen-Ting Chen T, Wang SI, Hung YM, Chen HY, Wei CJ. Risk of autoimmune diseases in patients with COVID-19: A retrospective cohort study. EClinicalMedicine. 2023 Feb;56:101783. doi: 10.1016/j.eclinm.2022.101783. Epub 2023 Jan 10. PMID: 36643619; PMCID: PMC9830133.
Chriswell ME, Lefferts AR, Clay MR, Hsu AR, Seifert J, Feser ML, Rims C, Bloom MS, Bemis EA, Liu S, Maerz MD, Frank DN, Demoruelle MK, Deane KD, James EA, Buckner JH, Robinson WH, Holers VM, Kuhn KA. Clonal IgA and IgG autoantibodies from individuals at risk for rheumatoid arthritis identify an arthritogenic strain of Subdoligranulum. Sci Transl Med. 2022 Oct 26;14(668):eabn5166. doi: 10.1126/scitranslmed.abn5166. Epub 2022 Oct 26. PMID: 36288282; PMCID: PMC9804515.
Metyas S, Chen C, Aung T, Ballester A, Cheav S. Rheumatologic Manifestations of Post SARS-CoV-2 Infection: A Case Series. Curr Rheumatol Rev. 2022;18(4):346-351. doi: 10.2174/1573397118666220211155716. PMID: 35152867.
Ordoñez-Cañizares MC, Mena-Vázquez N, Redondo-Rodriguez R, Manrique-Arija S, Jimenez-Núñez FG, Ureña-Garnica I, Fernández-Nebro A. Frequency of Polyautoimmunity in Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus. J Clin Rheumatol. 2022 Jan 1;28(1):e38-e43. doi: 10.1097/RHU.0000000000001574. PMID: 32956154.
PTPN22. National Institutes of Health, National Library of Medicine, National Center for Biotechnology Information. (2022, November 07). Retrieved December 04, 2022, from https://www.ncbi.nlm.nih.gov/gene/26191
Rheumatoid arthritis. Autoimmune Association. (2022, February 10). Retrieved December 04, 2022, from https://autoimmune.org/disease-information/rheumatoid-arthritis-ra/