Arthritis Can Be a Systemic Disease

When you think about arthritis, you likely think of a disease that affects the joints. However, some types of arthritis may have extra-articular manifestations, meaning that the disease affects areas of the body other than the joints. When this occurs, especially in multiple organ systems of the body, the arthritic disease is said to have systemic effects or is referred to as a systemic disease.

Types of arthritis that are classified as systemic diseases include:

• Rheumatoid arthritis
• Lupus erythematosus
• Juvenile arthritis
• Psoriatic arthritis
• Vasculitis
• Scleroderma
• Sjogren's syndrome

When arthritis affects the whole body, people may experience a wide range of symptoms. Examples of extra-articular involvement include:

• Fever
• Fatigue
• Weakness
• Anemia
• Nodules
• Dry eyes
• Dry mouth
• Pulmonary fibrosis
• Pleural effusion (excessive amount of fluid in the lungs)
• Nerve problems
• Gastrointestinal complications
• Skin complications
• Kidney disease

That's just a sampling from a more extensive list of possible systemic effects which can occur with arthritis and related rheumatic diseases. In fact, extra-articular manifestations can develop even when there is little active joint involvement. People may experience minimal joint pain, yet also experience a number of system-wide symptoms.

Not all rheumatoid arthritis patients develop complications outside of the joints. Patients are more likely to develop systemic complications if they are strongly positive for rheumatoid factor. Patients with rheumatoid arthritis may also experience symptoms that involve the cardiovascular and respiratory systems.

As you might expect, rheumatoid arthritis patients with systemic complications tend to do worse than those without such complications (i.e. prognosis is worse with systemic involvement).

Since we know some rheumatoid arthritis patients will develop only joint disease while others will develop systemic disease, you may be wondering why. That is a tough question, like asking why a person gets rheumatoid arthritis at all.

According to rheumatologist Scott J. Zashin, M.D., there is likely a mix of genetics and environmental factors that contribute to why certain cases of rheumatoid arthritis are systemic. The risk of systemic disease is greatly increased when a patient has anti-CCP or rheumatoid factor antibodies -- the presence of which is influenced by environmental factors, like smoking, and a person's genetic makeup.

There are over 100 types of arthritis. While we do not know for sure why some people experience joint pain and others develop systemic disease, we do know that systemic involvement is more likely with inflammatory types of arthritis.

For example, chronic systemic inflammation can be indirectly linked to causes of death in rheumatoid arthritis due to serious infections, cardiovascular disease, lymphoma, and accelerated atherosclerosis. Systemic disease is serious. Appropriate treatment focused on bringing inflammation under control is essential.