Letting the inflammation that accompanies RA go unchecked can cause anemia – a reduction in red blood cells characterized by headache and fatigue. Inflammation might also lead to thrombosis, or elevated blood platelet levels, and blood clots. Both conditions improve as the inflammation is controlled; anemia can be further addressed with iron supplements. On the other hand, aggressively treating inflammation with corticosteroids may cause thrombocytopenia, an abnormally low number of blood platelets. This, too, is addressed by stopping the medication.

Though it’s rare, people with longstanding RA can develop Felty syndrome, characterized by an enlarged spleen and low white blood cell count. This condition may lead to increased risk of infection and lymphoma, cancer of the lymph glands. Immunosuppressant drugs are the usual treatment.

Blood Vessels

It’s rare, but longstanding RA can also cause vasculitis, inflammation of small blood vessels that supply the skin. Such involvement may have serious consequences if not addressed, although aggressive treatment with methotrexate, corticosteroids and other drugs that control cell production usually resolves the problem. Vasculitis is often heralded by small red dots on the skin; more severe cases can cause ulcers on the legs, under fingernails or in nail beds.

Nervous System

Nerve problems in the arms or legs, such as numbness, tingling or weakness, sometimes occur with RA. People with RA may develop carpal tunnel syndrome, a common nerve condition in which the nerve that runs from the forearm to the hand is compressed by inflamed tissue, resulting in tingling, numbness and decreased grip strength.

Sjögren’s Syndrome

People with rheumatoid arthritis are at greater risk for Sjögren’s syndrome, a condition in which the immune system attacks the body’s moisture-producing glands. The result: eyes and mouth that feel dry and gritty. Dry eyes can be relieved with “artificial tear” eye drops. In severe cases, a surgical procedure to plug the tear ducts may help. 

If left untreated, the condition can result in eye infection and scarring of the conjunctiva – the membrane covering the white of the eye inside the eyelid. Prescription medications can stimulate saliva production; so can sucking on sugarless lemon drops or glycerin swabs. Good dental hygiene is a must, as bacteria tend to flourish in a dry mouth, leading to tooth decay and gum disease.