Rheumatoid arthritis (RA) can lessen the body’s ability to handle infection in two basic ways. When the inflammation is active- the patient is in a flare with poor overall control of the illness- the risk of infection is higher. Second, the medications used to control the disease and the inflammation can lessen the ability to fight infection. Finally, the stress of having inflammation in a major organ such as the gut can lead to difficulty with adequate nutrition, which also decreases the body’s ability to fight infection.
Patients with RA are at higher risk of infections overall. In some patients with RA, the lung can also be a target of inflammation, and there can be damage to the lungs. For patients with RA, the pre-existing damage in the lungs caused by the RA can make a superimposed bacterial infection more severe.
When RA isn’t treated, life expectancy is decreased. The excess deaths seen in RA are usually caused by cardiovascular disease, such as heart attacks. However, once RA is adequately treated and the inflammatory burden on the body is lessened, mortality and risk of heart disease returns to normal.
It is very important for patients with RA and all patients receiving immunosuppressant medications to be vigilant with hand hygiene, making sure to wash their hands frequently, particularly during the flu season and before meals or preparing food. In addition, be sure to stay up to date with vaccinations such as the yearly flu vaccine and pneumonia vaccine.
Dr. Susan Goodman is a rheumatologist at Hospital for Special Surgery. She specializes in the treatment of patients with inflammatory arthritis such as rheumatoid arthritis, psoriatic arthritis, and spondylarthritis.