Question: Systemic effects of RA - How common are systemic effects of RA?
Answer: The primary targets in rheumatoid disease are the joints of the musculoskeletal system, but since this is a systemic disease, many other organ systems may also become involved. Examples of extra-articular involvement include fever, anorexia, fatigue, weakness, swollen lymph nodes, anemia, nodules, dry eyes, fibrosis of the lungs, fluid in the chest cavity, vasculitis, neuropathy, GI, and kidney disease. Fortunately not all rheumatoid arthritis (RA) patients develop these extra-articular manifestations, and the prognosis for RA is quite variable. Patients with high titer rheumatoid factor, subcutaneous nodules and a slow insidious onset of disease are more likely to develop one or more of the above complications. The majority of patients with chronic unremitting disease exhibit some form of extra-articular disease, and the morbidity and mortality for these patients is higher than in the unaffected RA population. (Answer provided by the late Dr. Raymond Federman, aka Dr. Bones, who passed away on September 2, 2003. The care of his patients even in retirement was always his joy.)
