Rheumatoid arthritis (RA) is a chronic autoimmune condition that primarily impacts the joints. RA is a systemic disease, affecting various other organs and systems. Among these, the lymphatic system, a crucial part of the body’s immune defense, can also be affected. Small, bean-shaped glands called lymph nodes, integral to this system, may become swollen in individuals with RA.
Understanding Lymph Nodes
Lymph nodes are small, kidney-shaped structures that are part of the lymphatic system, a network of vessels and organs vital for immune function. These nodes are strategically distributed throughout the body, including clusters in the neck, armpits, and groin. They act as filters for lymph fluid, a watery substance that circulates throughout the body.
Inside the lymph nodes, various immune cells are stored and activated. As lymph fluid passes through, these cells identify and neutralize harmful substances like bacteria, viruses, and abnormal cells, including cancer cells. This filtering process protects the body from infections and diseases.
Causes of Lymph Node Swelling
Lymph nodes typically swell, a condition known as lymphadenopathy, when the body is actively fighting an infection or illness. This enlargement occurs because immune cells within the nodes multiply rapidly to combat perceived threats.
Common causes of swollen lymph nodes include viral infections, such as the common cold, flu, or mononucleosis, and bacterial infections like strep throat or skin infections. When an infection is present, the lymph nodes closest to the affected area are often the first to swell. While infections are the most frequent cause, inflammatory conditions and some medications can also lead to lymph node enlargement.
Lymph Nodes Commonly Affected by Rheumatoid Arthritis
Rheumatoid arthritis can cause lymph nodes to swell, often reflecting heightened disease activity. This swelling, known as rheumatoid lymphadenopathy, is a recognized extra-articular manifestation of RA. The enlargement is typically due to the chronic inflammation associated with RA and an overactive immune system.
Specific regions where lymph nodes are frequently observed to swell in individuals with RA include the neck (cervical), armpits (axillary), and groin (inguinal). Epitrochlear lymph nodes, located above the elbow, can also be affected, sometimes indicating activity in the hand joints. Swelling in these areas is often localized, particularly near joints experiencing active inflammation, but generalized lymphadenopathy can also occur, especially at the onset of RA. These nodes are usually described as moderately swollen, firm, mobile, and typically not painful.
What Swollen Lymph Nodes Mean in RA
When a person with rheumatoid arthritis experiences swollen lymph nodes, it often indicates ongoing or heightened disease activity. The chronic inflammation characteristic of RA can lead to increased immune cell activity within the lymph nodes, causing them to enlarge.
However, swollen lymph nodes in an RA patient are not exclusively due to RA itself; other conditions, such as infections or, rarely, lymphoma, can also be the cause. Individuals with RA have a slightly increased risk of developing lymphoma, a cancer of the lymphatic system. This elevated risk is thought to be linked to the persistent immune system overstimulation and inflammation inherent in RA.
If an RA patient notices swollen lymph nodes, particularly if they are large, painful, rapidly growing, or accompanied by symptoms like fever, unexplained weight loss, or night sweats, seeking medical advice is important. Healthcare providers will typically evaluate the swollen nodes through a physical examination, and may order blood tests to assess inflammation markers or conduct imaging studies. In rare instances, a biopsy of the lymph node might be performed to rule out other conditions, including lymphoma.