What Is Autoimmune Arthritis?
An autoimmune disease is one in which the body's immune system mistakenly attacks normal cells. In autoimmune arthritis, which includes rheumatoid arthritis (RA), the immune system attacks the lining of the joints. This leads to inflammation that can affect the entire body.
Symptoms vary greatly from person to person, as does the rate of progression. While there’s no cure for this chronic condition, there are a variety of treatments that can help improve your quality of life.
According to womenshealth.gov, more than 23.5 million people in the United States are affected by an autoimmune disease. It’s one of the top causes of disability and death.
The Centers for Disease Control and Prevention (CDC) reports that about 1.5 million adults in the United States have RA. An estimated 294,000 children in the United States live with some form of arthritis or rheumatic condition.
Your likelihood of developing RA can be affected by risk factors such as:
- your gender: women develop RA at a higher rate than men
- your age: RA can develop at any age, but most people begin to notice symptoms between the ages of 49 and 60 years
- your family history: you’re at increased risk of having RA if other family members have it
- smoking: cigarette smoking can increase your chances of developing RA; quitting can lower your risk
Symptoms generally begin slowly and can come and go. Joint pain and inflammation affect both sides of the body equally, and can be marked by these signs:
- deformed joints
- hard bumps of tissue under the skin on your arms (nodules)
- reduced range of motion
- dry mouth
- difficulty sleeping, fatigue
- weight loss
- eye inflammation, dry eyes, itchy eyes, eye discharge
- chest pain when you breathe (pleurisy)
Autoimmune diseases tend to share symptoms with other conditions, so diagnosis can be difficult, particularly in the early stages. There’s no one test that can specifically diagnose RA. Instead, diagnosis involves clinical examination, patient-reported symptoms, and medical tests, including:
- rheumatoid factor test
- anti-cyclic citrullinated peptide antibody test
- blood count
- erythrocyte sedimentation rate and/or c-reactive protein
- X-rays, ultrasound, MRI
You can help with diagnosis by giving your doctor your complete medical history and keeping a record of symptoms. Don't hesitate to seek a second opinion from a specialist (rheumatologist).
RA requires ongoing care by a rheumatologist. Treatment varies according to symptoms and disease progression. However, your rheumatologist may recommend medications such as:
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- disease modifying antirheumatic drugs (DMARDs)
- biologic agents
- immunosuppressants (DMARDs)
- TNF-alpha inhibitors (biologic)
A physical therapist can teach you the proper way to exercise. Physical Therapy (PT) is another option that can help reduce pain and improve flexibility. In extreme cases, you may need surgery to repair or replace damaged joints and assistive devices such as canes, crutches, and grab bars.
Excess weight stresses joints, so try to maintain a healthy diet and perform gentle exercises to improve your range of motion. Applying cold to joints can numb pain and ease swelling, and heat can soothe aching muscles.
Stress can intensify symptoms, so stress-reducing techniques like tai chi, deep breathing exercises, and meditation may be helpful and relaxing. Most people with RA need eight to 10 hours of sleep a night. If that's not enough, try to nap during the day.
People with RA have an increased risk of heart and lung diseases, so don't smoke!
Complications from RA include carpel tunnel syndrome, osteoporosis, and damage to the cervical spine (neck). Lung complications include:
- tissue damage
- blockage of small airways (bronchiolitis obliterans)
- high blood pressure of the lung (pulmonary hypertension)
- fluid in the chest (pleural effusions)
- scarring (pulmonary fibrosis)
Heart complications include:
- hardening of arteries
- inflammation of the outer lining of the heart (pericarditis)
- inflammation of heart muscle (myocarditis)
- inflammation of blood vessels (rheumatoid vasculitis)
- congestive heart failure
Your prognosis will depend on many factors, such as your overall health and your age at diagnosis. Another important factor is whether you test positive for a protein called rheumatoid factor (RF) and/or citrullinated peptide (CCP Ab).
Your treatment plan—how early it began, and how well you follow it—will also influence your prognosis. To improve your outlook, make smart lifestyle choices like not smoking, getting regular exercise, and choosing healthy foods. Early treatment and new medications are helping to improve life for people with RA.