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Johns Hopkins Health Alert

Why Do Some People Get Rheumatoid Arthritis?

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Several factors may increase your risk of developing rheumatoid arthritis, but for now the true cause of rheumatoid arthritis remains a mystery.

Rheumatoid arthritis affects approximately 1.3 million Americans. Unlike osteoarthritis, which occurs equally in both sexes, more than three times as many women as men have rheumatoid arthritis. Osteoarthritis usually begins late in life; rheumatoid arthritis often begins between ages 30 and 50, though it can develop at any age.

The major distinguishing characteristic of rheumatoid arthritis is that it is a chronic, systemic (affecting the whole body), inflammatory autoimmune disease. What does this mean? In an autoimmune disease, something triggers the body to mount an immune system attack against itself, much the way the immune system normally attacks harmful bacteria and viruses. In rheumatoid arthritis, the primary target of this attack is the synovial membrane that lines joints in every part of the body.

The exact cause of rheumatoid arthritis is still unknown, but researchers have identified some factors that may increase your risk of developing the disease.

  • The Role of Genetics and Rheumatoid Arthritis
    Rheumatoid arthritis can run in a family. But even if you have rheumatoid arthritis, your children’s risk of developing it is not greatly increased. Researchers have identified a specific genetic marker called HLA-DR4, which is found in more than two thirds of white men and women who have rheumatoid arthritis. However, about 20 percent of people without rheumatoid arthritis have the same genetic marker. So having the marker increases your risk of rheumatoid arthritis but does not mean that you’ll inevitably develop the disease.
  • The Role of Infection and Rheumatoid Arthritis.
    Several types of arthritis occur as a result of infections. You’re probably familiar with Lyme disease, which is the result of a bite from an infected deer tick. The bacterium the tick transmits first causes a rash, fever and neck stiffness. Weeks later, victims may develop severe joint inflammation (Lyme arthritis) that can last for months or even for a lifetime. Some researchers think that in people who are genetically susceptible to rheumatoid arthritis, exposure to certain bacteria or viruses can trigger the abnormal immune response that causes the disease.
  • Environmental Factors and Rheumatoid Arthritis.
    Several studies have found that heavy smokers are more likely to develop rheumatoid arthritis than nonsmokers. Other studies suggest that drinking coffee might also increase the risk of rheumatoid arthritis and that drinking tea might decrease the risk. However, a review of data from more than 80,000 women studied for nearly 20 years concluded that neither beverage affects rheumatoid arthritis risk.

Posted in Arthritis on January 5, 2007
Reviewed June 2011


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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.


I had a post op infection in August of 2010, after I was hospitalized for the infection I started noticing unusual symptoms, first I had stiff ankles upon rising in the mornings, the symptoms progressed to swollen hands, swollen feet and ankles and it seemed that every joint I had hurt, after many test and periods of taking prednisone I was diagnosed with RA on Feb. 3, 2011. Even though my blood work is negative (20% of RA patients have negative blood work) with my symptoms, and every time I came off the prednisone my symptoms came back my Dr gave me a positive diagnosis for RA. I am currently taking plaquenil and the meds have not started helping yet, I am miserable and upon rising for about the first 3 hours are the very worst. Has anyone experienced the same thing, upon a post op infection then being diagnosed with RA, before the infection I had never in my life experienced any signs or symptoms of RA. I am seeking the help of an attorney. I think the Dr and hospital should be held accountable for the infection that has caused me to have a life long chronic illness, this illness is already affecting my ability to work.

Posted by: C Grey | February 16, 2011 8:21 PM

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