About Rheumatoid Arthritis & Tuberculosis
Rheumatoid arthritis is one of the most common forms of arthritis, affecting over 2.1 million Americans alone. This painful and crippling condition can often be eased with certain drugs known as disease-modifying antirhematic drugs (or DMARDs) and tumor necrosis factor-alpha antagonists (TNF-a). Unfortunately, DMARDs and TNF-a can make a person with rheumatoid arthritis more prone to get tuberculosis.
Other People Are Reading
-
Features
-
Rheumatoid arthritis symptoms are very painful, making a patient's joints stiff, swollen and warm. Often, if one joint like a wrist is affected, the other wrist will be, too. Sometimes there is fever and a feeling of unease or doom. It can affect anyone but tends to affect senior citizens. Tuberculosis patients often will not realize anything is wrong until the disease is advanced. Symptoms include coughing, fever, night sweats, poor appetite and little energy. Later on, the patient loses weight, has difficulty breathing and coughs up blood.
Significance
-
Not much is known about rheumatoid arthritis, but it seems to be a disease of the body's immune system as opposed to just regular wear and tear of the joints. The body is attacking itself inside of your joints, causing them to swell up and be hard to move. Immuno-suppressant drugs like DMARDs are good at combating this, along with painkillers and some lifestyle changes like regular exercise. TNF-a drugs work by stopping the body's production of a chemical that tells parts of the body to become swollen and hot. However, studies have shown that people on these drugs often get tuberculosis (see Resources for links to two studies).
-
Prevention/Solution
-
Any patient on DMARDs or TNF-a drugs have to be monitored for tuberculosis and told up front that one of the drugs' side effects is tuberculosis. People with rheumatoid arthritis who are particularly at risk are the homeless, prisoners, health care workers, seniors in retirement communities and people in hospitals.
Considerations
-
There are other families of drugs used in treating rheumatoid arthritis, but some patients only find relief with DMARDs or TNF-a. When patients are facing the concrete reality of rheumatoid arthritis pain now, they are often willing to take chances with drugs that may predispose them to a potentially deadly disease like tuberculosis.
Theories/Speculation
-
Since rheumatoid arthritis is so complex, managing the pain and swelling is also complex. Drugs alone can't solve it. Anything to strengthen the body's natural immune system and keep the joints flexible is to be encouraged. Regular sleep, a balanced diet, learning how to manage stress and quitting smoking all can help the body help itself over the long run.
-
Resources
- Photo Credit Arthritic hands. Images from Wikimedia Commons
