Is Rheumatoid Arthritis Hereditary?

Should your children be tested?

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If you have rheumatoid arthritis (RA), or your parent does, you might ask, "Is rheumatoid arthritis hereditary?" Strictly speaking, no: It's not hereditary, meaning no one is guaranteed to get it based on genetics alone. However, your genes can increase the risk that you'll develop RA. Researchers have found genetic markers in people with this autoimmune disorder that are tied to chronic inflammation, the immune system, and the disease itself.

Family History and Genetics

If you have a close relative with RA, your risk of developing it is increased. Some research estimates that genetics make up about 60% of the risk. However, it's not as simple as "my mom had it so I'll have it." Instead, one or both of your parents may have had a particular genetic makeup (not a single gene or genetic mutation) that put them at-risk for RA, and they may have passed that risk on to you.

It generally takes more than genetics to trigger RA, though. Environmental and lifestyle factors contribute, as well. Certain infections, injury, long-term cigarette smoking, exposure to certain dusts or fibers, obesity, stress, and many more factors, when combined with genetics, may up the odds of RA developing in you. .

More than 100 genes are linked or suspected of being linked to RA. The most significant ones are variations of human leukocyte antigen (HLA) genes. Those genes produce proteins that help your immune system tell different kinds of cells apart—specifically, distinguishing viruses, bacteria, and other foreign invaders from the healthy cells that make up your body.

Along with HLA genes, some of genetic markers that increase your risk of developing RA include:

  • STAT4: Helps regulate and activate the immune system
  • TRAF1 and C5: Contribute to chronic inflammation
  • PTPN22: Linked to onset and progression of RA

Some people with RA test positive for some or all of these genetic markers while other people are negative.

RA is autoimmune, which means your immune system can't differentiate dangerous cells from the cells that make up your joints and the lining of your joints. Therefore, your immune system attacks them all.

On top of genetic markers, many people with RA (but not all) test positive for rheumatoid factor (RF) and antinuclear antibodies (ANA). These are both substances that attack proteins inside your cells. They're linked to autoimmunity in general and to many cases of RA.

Should Your Children Be Tested?

Since blood tests can help diagnose arthritis, parents often wonder if their children could be tested for RA, including the genetic marker HLA-B27, RF, and ANA, to see what the future may hold.

This usually isn't something doctors recommend. When asked how useful it would be to test children of adults with RA, rheumatologist Scott J. Zashin, MD, said:

"I do not recommend testing the blood of children without clinical symptoms whose parents have arthritis. These children are more likely to test positive for rheumatoid factor, ANA, and HLA-B27 and never develop the rheumatologic condition. Typically, no more than 10% of children from a parent with arthritis will develop a similar problem. On the other hand, if a child presents with the signs and symptoms of chronic arthritis such as rheumatoid arthritis, lupus, or ankylosing spondylitis, then it is quite reasonable to obtain the appropriate lab work."

A Word From Verywell

The bottom line is that you shouldn't feel like you need to have your children tested for markers of rheumatoid arthritis because no matter what the results are, you won't truly know whether they'll eventually have RA. If they're showing arthritis warning signs, however, definitely talk to your doctor about testing.

Because your RA (or another close relative's) means your child already has an elevated risk, make sure they know about the controllable risk facts, such as cigarette smoking, so they can take steps throughout their life to keep their risk as low as possible.

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Article Sources
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  1. Kurkó J, Besenyei T, Laki J, Glant TT, Mikecz K, Szekanecz Z. Genetics of rheumatoid arthritis - a comprehensive reviewClin Rev Allergy Immunol. 2013;45(2):170-179. doi:10.1007/s12016-012-8346-7

  2. National Institutes of Health: U.S. National Library of Medicine. Rheumatoid arthritis. Updated June 9, 2020.

  3. Cleveland Clinic: healthessentials. Is arthritis hereditary? Updated June 17, 2019.

Additional Reading
  • Answer provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is the author of Arthritis Without Pain - The Miracle of Anti-TNF Blockers and co-author of Natural Arthritis Treatment.