Rheumatoid Arthritis Muscle Wasting: Rheumatoid Cachexia

Tags: , , , ,

Wasting time on Rheumatoid Arthritis muscle wasting?

Rheumatoid Arthritis is famous for bone erosions and joint deformity. That’s bad enough, but RA doesn’t stop there. Rheumatoid Arthritis is a systemic disease which can affect all organs and systems in the body.

One of the first RA symptoms I experienced was extreme weakness in muscles and tendons. As RA moved through my joints, they could no longer support any weight. I might fall as my hip just gave way. Trying to lift a mug was impossible. It would cause my wrist to droop or my fingers to pull out of line. Will power did not matter. This from a girl who could do dozens of push-ups only weeks before.

Early in my RA treatment, I worried out loud to the rheumatologist about muscle wasting from being unable to do very much. The RA doc said, “This is not a concern.” I still worried because at the time, I couldn’t wash my own hair.

Almost overnight, I went from lifting 50 pound bags of concrete mix or fertilizer to being unable to hold onto a glass of water. Maybe it’s just me, but I became convinced that RA must be affecting my muscles, tendons, or ligaments. I have not found many clear answers, but one that I have found interesting is Rheumatoid Arthritis muscle wasting or Rheumatoid cachexia.

What does Rheumatoid Arthritis muscle wasting / cachexia mean?

These words refer to the loss of muscle mass and strength which is typical of certain serious diseases, including Rheumatoid Arthritis. Rheumatoid cachexia refers to cachexia in Rheumatoid Arthritis patients.

Here’s a ten dollar answer from Revista Brasileira de Reumatologia June 2009: “Frequently, patients with chronic or terminal diseases, such as cancer, AIDS, congestive heart failure, tuberculosis, chronic obstructive pulmonary disease, cystic fibrosis, rheumatoid arthritis (RA), Crohn’s disease, and others, present cachexia. Table 1 shows the main metabolic changes found in cachexia. Cachexia associated with RA was first described in 1873 by Sir James Paget; this term refers to body cell mass loss and high energy consumption at rest, which occurs in RA…”

One recent (2009) study about Rheumatoid Arthritis cachexia found that cachexia was present in 1of every four to five Rheumatoid Arthritis patients of low disease activity (“controlled RA”.). Rheumatoid Arthritis muscle wasting was found not to be associated with improper diet. They looked at metabolism changes as a possible connection to the cardiovascular disease of RA, suggesting “the increased prevalence of coronary heart disease in RA patients may, at least in part, be attributed to inflammation and change of fat metabolism.”

Some facts about Rheumatoid Arthritis muscle wasting /Rheumatoid cachexia

Here are some valuable excerpts from the associated editorial in Arthritis Research and Therapy:

  • Weight loss and muscle wasting are common features of untreated RA, as originally described by James Paget in the 19th century. However, rheumatoid cachexia, from the Greek meaning ‘bad condition’, was not recognized as a common problem among patients with RA until relatively recently.
  • Rheumatoid cachexia refers to the loss of fat-free mass, predominantly skeletal muscle, that occurs in RA. Loss of body weight does not always occur; in fact, loss of body fat-free mass is often accompanied by increased fat mass and stable body weight. Rheumatoid cachexia may affect up to two-thirds of all patients with RA
  • Despite great advances in the treatment of RA, it appears that rheumatoid cachexia persists even after joint inflammation improves.
  • Rheumatoid cachexia may be an important risk factor for cardiovascular disease and excess mortality in RA.
  • Elkan and colleagues demonstrate a link between rheumatoid cachexia and metabolic syndrome, further reinforcing the need for therapy directed beyond inflammation and at the metabolic consequences of RA.
  • Evidence from cancer, heart failure, and HIV infection strongly points to weight loss as an independent predictor of poor outcome (reviewed in). The average loss of fat-free mass among patients with RA is between 13% and 15% – approximately one-third of the maximum survivable loss of fat-free mass.
  • Loss of fat-free mass and higher fat mass are each associated with greater disability in RA, and low body weight (that is, both fat and fat-free tissue) in patients with RAis associated with threefold higher mortality. Thus, rheumatoid cachexia may be an important contributor to increased morbidity and premature mortality in RA

Was it Rheumatoid cachexia?

I don’t know if cachexia is what affected my muscles so greatly. Actually I doubt that was the only factor for me because of the suddenness of the symptoms. I have a few other clues to pursue. The quest continues.

Recommended reading:

NOTE: Your comments are an important resource for future readers of this post in the months to come. Please find the comment link below each post.

Click here to read all the comments or add yours!

Kelly Young. All rights reserved.

This entry was posted on Wednesday, July 7th, 2010 at 7:59 am and is filed under RA Education. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

Advertisement

The Post

Comments (46)


What do you think?