Rheumatoid arthritis (RA) is an autoimmune disease that primarily affects the joints, causing inflammation, pain, stiffness, and swelling.

However, in addition to joint symptoms, many individuals with RA also experience systemic symptoms such as fatigue, loss of appetite, and fever. This article aims to explore the connection between rheumatoid arthritis and fever, providing insights into the underlying mechanisms and potential explanations for this symptom.

Understanding Rheumatoid Arthritis

Rheumatoid arthritis is a chronic inflammatory disorder characterized by the body’s immune system mistakenly attacking its own healthy tissues, primarily targeting the synovium – the lining of the joints.

This immune response leads to joint inflammation, cartilage and bone damage, and eventually joint deformity.

Overview of Fever

Fever is generally defined as an elevation in body temperature above the normal range of 36.5–37.5°C (97.7–99.5°F). It is a common symptom of various illnesses and infections, often signaling an ongoing immune response within the body.

Fever is believed to be a defense mechanism in response to infection or inflammation, as higher temperatures enhance immune function and inhibit the growth of certain pathogens.

The Link between RA and Fever

Although fever is not considered a primary symptom of rheumatoid arthritis, studies have shown that it can occur in a significant number of RA patients.

Research suggests that the fever experienced by individuals with rheumatoid arthritis is typically low-grade, ranging from around 99.5–100.9°F (37.5–38.3°C). This fever may arise due to several interrelated factors:.

Inflammation and Immune Response

Rheumatoid arthritis is characterized by chronic inflammation in the joints, triggered by an overactive immune system. This inflammation releases various pro-inflammatory molecules, such as cytokines, into the bloodstream.

Some of these molecules, like interleukin-6 (IL-6), can directly stimulate the hypothalamus – the part of the brain responsible for regulating body temperature – potentially leading to fever.

Infection and Secondary Factors

Individuals with rheumatoid arthritis are often at an increased risk of infections due to the disease itself and the immunosuppressive medications used to manage it. Infections can elicit an immune response and cause fever.

Additionally, certain medications commonly prescribed for RA, such as disease-modifying antirheumatic drugs (DMARDs) and biologic agents, can have fever as a side effect.

Flares and Systemic Involvement

Rheumatoid arthritis flares are periods of increased disease activity when symptoms worsen. During flares, systemic inflammation can occur, affecting various organs and tissues throughout the body.

This systemic involvement, along with the release of pro-inflammatory molecules, can contribute to the development of fever in some individuals with RA.

Impact on Disease Progression

The presence of fever in rheumatoid arthritis may also have implications for disease progression. Studies have shown that persistent or recurrent fever in RA patients is associated with increased joint damage and disability.

It is believed that ongoing inflammation and immune activation, as reflected by fever, can worsen the underlying joint pathology and contribute to more severe disease outcomes.

When to Seek Medical Attention

While low-grade fever is relatively common in individuals with rheumatoid arthritis, it is important to be cautious and monitor any changes in symptoms. It is recommended to seek medical attention if:.

The fever persists for more than a few days
The fever is high-grade (above 101.3°F or 38.5°C)
There are other severe symptoms accompanying the fever

An accurate diagnosis and appropriate treatment are essential to manage both the underlying rheumatoid arthritis and any potential concurrent infections or complications.

Conclusion

Rheumatoid arthritis is a complex autoimmune disease that affects not only the joints but also various other systems within the body. Although fever is not a primary symptom of RA, it can occur in some individuals, typically as a low-grade fever.

The underlying mechanisms for fever in rheumatoid arthritis involve inflammation, immune responses, infections, and the impact of systemic involvement. Recognizing the presence of fever and seeking appropriate medical attention when needed is crucial for effective management of both the underlying condition and potential complications.