From healthcentral.com
When inflammation is high, these bean-shaped glands kick into overdrive—and may make themselves more noticeable
Like many parts of the body, the lymph nodes are invisible labourers: We tend not to appreciate the work they do until they start acting up. Located throughout the body, these small, bean-shaped glands belong to the lymphatic system, a network of fluid-filled channels that are part of the immune system, according to the National Library of Medicine. When you have an autoimmune condition, like rheumatoid arthritis (RA), your immune system is constantly on high alert fighting off what it perceives to be a foreign invader. For some people, that may translate to swollen lymph nodes, particularly when the disease isn’t well controlled.
Can RA Cause Swollen Lymph Nodes?
The lymph nodes’ primary job is to filter out harmful substances, like germs and other foreign substances, per the NLM. They do this all day every day without our awareness, but when they have to kick into high gear to fight off an enemy (like an infection or a malignancy) they produce so many immune cells that it causes them to swell—sometimes, getting big enough that you can feel them in the areas where they cluster: your neck, underarms, abdomen, or groin.
Swelling of the lymph nodes is known as lymphadenopathy. For some people, it’s a symptom of RA. “It’s possible for active RA inflammation to include the lymph nodes,” says Charis Meng, M.D., rheumatologist at Hospital for Special Surgery in New York City. Swollen lymph nodes are quite common in RA, with some studies finding that up to 82% of people with the disease experience it, according to research on lymphadenopathy in rheumatological conditions published in Rheumatology. RA tends to affect the lymph nodes near actively inflamed joints in particular, though the research notes that less commonly, people may experience more generalised lymph node swelling (in two or more areas) along with symptoms like fever, weight loss, and fatigue as early signs of RA.
Exactly why lymph nodes swell with RA is unclear, but experts suggest that it has something to do with the role of the lymph nodes in managing inflammation. “The lymph nodes are like the little trash collectors of the body, so when the body is inflamed and trying to fight off different things, the lymph nodes can become big and swollen,” Daniele Marcy, M.D., a fellow in rheumatology at the University of Colorado Anschutz Medical Campus in Aurora, CO. It’s not that RA attacks the lymph nodes, but that the inflammation of RA kicks this part of the immune system into high gear.
Other Possible Causes of Swollen Lymph Nodes
If your RA is very active—you’re experiencing a lot of joint inflammation and pain and swelling —and you have swollen lymph nodes, the two could be related, Dr. Meng says. But if your RA is well controlled or you’re experiencing other symptoms, then it’s more likely something else is causing these glands to swell up. Common causes of swollen lymph nodes include:
Colds, flus, and other viruses
Ear infections
Skin infections
Mononucleosis
Tonsillitis
Sexually transmitted infections
Recent vaccination
Lymphoma and leukemia
Certain medications
To get rid of swollen lymph nodes, you’ll need to treat whatever is causing them—or, in some cases, just wait it out. For example, you may require antibiotics if you have a bacterial infection that can be treated with one. If you’ve started a new medication recently, your doctor can help you determine if that’s causing your swelling and whether to discontinue it. If you have a virus, you may just need to take medication like acetaminophen or ibuprofen to address your symptoms and help with the inflammation until your body fights it off, Dr. Marcy says. If the swelling is a reaction to a vaccine, it should start to go down within a week, and be gone by about two weeks at most, Dr. Marcy adds.
If lymph node swelling is related to RA, getting on the right RA treatment should resolve the swelling, too, Dr. Meng says.
Rheumatoid Arthritis and Lymphoma
You may or may not be aware that there is an association between RA and lymphoma, cancer that begins in the lymphatic system and can cause swollen lymph nodes as an early symptom. “In general, with any chronic inflammatory condition, including RA, there can be an increased risk of lymphoma,” Dr. Meng says. When the immune system is chronically overstimulated, it’s too busy fighting itself to function optimally, which can ultimately increase the chances that cancer can develop, she explains. People with RA have a 10 to 30% higher risk of cancer than the general population, and a 60 to 80% higher risk of lymphoma in particular, according to a study on cancer risk in RA in The Lancet Regional Health.
However, Dr. Marcy notes that the overall risk of developing lymphoma remains quite low. Dr. Meng agrees, “The risk is about 2% in the general population, so doubling that for a person with RA, we’re still talking pretty small numbers.”
This is another reason why it’s important to get on the right RA treatment, to support the healthy functioning of the immune system. “Successful treatment of RA, where inflammation is reduced, has been shown to reduce mortality in general,” Dr. Meng says. “We can reduce these risks with good treatment.”
When to Talk to Your Doctor
If you have RA and are experiencing swelling in your lymph nodes, Dr. Meng says it’s a good idea to mention it to your rheumatologist, so they can keep track of it. Once you’re on treatment and your other RA symptoms begin improving, the lymph node swelling should resolve, too; if it’s been three or four weeks and they’re still swollen or getting larger, let your doctor know, she says. They may want to run additional tests to make sure you’re responding to your RA medications and there isn’t something else putting extra strain on your immune system and causing the swelling.
Takeaways
If you have RA and are experiencing a lot of inflammation, you may notice some of your lymph nodes are larger than normal. This usually isn’t anything to be worried about, and once you control the inflammation with RA treatment, the swelling should go down. Your lymph nodes could be swollen for another reason, such as an infection or illness that will pass on its own or easily with treatment (like antibiotics).
Rarely, swollen lymph nodes could be a sign of lymphoma, a type of cancer of the lymphatic system that people with RA tend to get at higher rates than people without the condition. If you have swollen lymph nodes that aren’t associated with an illness or infection, or that persist despite getting your joint pain and inflammation under control, talk with your doctor, who can help you figure out what’s causing the swelling and how to treat it, if necessary.
https://www.healthcentral.com/condition/rheumatoid-arthritis/rheumatoid-arthritis-lymph-nodes
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