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Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints. Rheumatoid arthritis can also cause inflammation of the tissue around the joints, as well as in other organs in the body (Arthritis community nd).
Autoimmune diseases are illnesses that occur when the body's tissues are mistakenly attacked by their own immune system which is one of the main roles of the lymphatic system. The immune system is a complex organization of cells and antibodies which are designed normally to "seek and destroy" invaders of the body, mainly infections. Patients with autoimmune diseases have antibodies in their blood that target their own body tissues, where they can be associated with inflammation. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease (nhs.uk, nd). The immune system produces specialized cells and chemicals, which are released into the bloodstream and begin to attack body tissues. This abnormal immune response causes an inflamed, thickened synovium, the membrane that lines the joint. Inflammation of the synovium is called synovitis and is the hallmark of an inflammatory arthritis such as rheumatoid arthritis (emedicinehealth.com 2010). As the synovitis expands inside and outside of the joint, it can damage the bone and cartilage of the joint and the surrounding tissues, such as, nerves, tendons, ligaments , and blood vessels.
Rheumatoid arthritis occurs when white blood cells move away from the blood stream into the membranes that surround the joints. The initial stage of the disease is when these blood cells inflame the synovium or joint lining. The next stage is when the inflammation causes a release of proteins, which thickens the lining. In the final stage, the protein not only thickens the lining, but also damages the cartilage, bone, tendons and ligaments located near the joint. The disease starts in small joints first. The most Common joints affected are the wrist, fingers, ankles and toes. Then, the disease moves to larger areas such as the shoulders, elbows, knees and hips. Damage to the joints inhibits the ability to perform daily tasks (e.how.com 2010).
Although rheumatoid arthritis most often affects the joints, it is a disease of the entire body (systemic illness). It can affect many organs and body systems besides the joints (Rodwell 1994).
Musculoskeletal: Damage to muscles surrounding joints may cause shrinking and weakening known as atrophy. This is most common in the hands. Atrophy also may result from not using a muscle, usually because of pain and swelling. Damage to the bones and tendons can cause deformities, mainly in the hands and feet.
Nervous system: The deformity and damage to joints in RA often lead to entrapment of nerves. Carpal tunnel syndrome is one example of this. Entrapment can cause serious damage to the nerves.
Heart: A collection of fluid around the heart from inflammation is not uncommon in rheumatoid arthritis. This usually only causes mild symptoms, if any, but it can be very severe. Rheumatoid arthritis-related inflammation can affect the heart muscle, the heart valves, or the blood vessels of the heart -coronary arteries (wellsphere.com 2008).
Lungs: Rheumatoid arthritis' effects on the lungs may take several forms. Fluid may collect around one or both lungs and is referred to as pleuritis. Less commonly the lung tissues may become stiff or overgrown, referred to as pulmonary fibrosis. Any of these effects can have a negative effect on breathing.
Digestive tract: The digestive tract is not usually affected directly by rheumatoid arthritis. Digestive complications are much more likely to be caused by medications used to treat the condition, such as gastritis (stomach inflammation) or stomach ulcer caused by NSAID therapy (non-steroidal anti inflammatory drugs). Any part of the digestive tract may become inflamed if the patient develops vasculitis which is inflammation of the blood vessels, but this is uncommon. If the liver is involved (10%), it may become enlarged and cause discomfort in the abdomen(emedicine.com, nd)
Kidneys: The kidneys are not usually affected directly by rheumatoid arthritis. Kidney problems in rheumatoid arthritis is more likely to be caused by medications used to treat the condition (nhs.uk 2010).
Blood vessels: Inflammation of the blood vessels can cause problems in any organ but are more common in the skin, where they appear as skin ulcers or purpura, which are purple patches on the skin caused by damage to the blood vessels. (A Bouley 2010).
Blood: Anaemia or "low blood" is a common complication of rheumatoid arthritis. Anaemia means that you have an abnormally low number of red blood cells and that these cells are low in haemoglobin, the substance that carries oxygen through the body (Answers.com, 2010).
Skin: Some people with RA form small nodules on or near the joint that are visible under the skin. Dark purplish areas on the skin are caused by bleeding into the skin from blood vessels damaged by rheumatoid arthritis. This damage to the blood vessels may also cause skin ulcers.
Rheumatoid arthritis is a disease possibly caused by a deficiency within the endocrine system. When the system is functioning correctly, endocrine secretions help to integrate and control the body's metabolic activity. When the endocrine system malfunctions, possibly due to chemical imbalances in the blood stream, this can result in the soft tissues surrounding the joint becoming inflamed and very painful to move (The arthritic association nd).