Autoimmune disease can cause more than just joint pain. It may also target multiple organs.
Psoriatic arthritis, also known as autoimmune skin disease, affects the skin and joints. The disease can affect many parts of your body and the symptoms may vary.
Christopher Ritchlin MD, MPH is a New York-based rheumatologist who diagnoses psoriatic arthritis as a cause of inflammation. I don’t think patients realize that inflammation can lead to inflammation in other parts of the body.
These are eight ways that psoriatic arthritis could affect your body in surprising ways:
1. The Heart Health Connection and Psoriatic Arthritis
A meta-analysis published in the journal Arthritis Care and Research found that people with psoriatic inflammation were 33% more likely to develop or have heart disease than the general population. A 31% higher chance of developing heart disease was also observed in this group.
Dr. Ritchlin says that it isn’t known why patients are at high risk. People with psoriatic disease are more likely to develop metabolic syndrome, a group of conditions that increases the risk of developing heart disease. He says that there are also patients with psoriatic and not-metabolic syndrome who are at higher risk of heart disease.
2. Uveitis and other eye problems are at higher risk
Psoriatic arthritis can increase your risk of developing uveitis, a condition that causes inflammation in the middle of the eye (under the white).
The National Psoriasis Foundation, (NPF) estimates that about 7 percent of people suffering from psoriatic arthritis will develop it. Uveitis, if not treated promptly, can cause vision loss.
Although the reasons behind this increased risk are not clear, it is possible that the inflammation that causes the joints to flare can also cause some eye tissues to become damaged.
According to an article in The Review of Optometry, people with the gene for human leukocyte antigen B27 (HLA) may be at higher risk of developing psoriatic arthritis or uveitis.
People with psoriatic disease are more likely to have other eye problems such as glaucoma or cataracts. This is especially true if they have been taking steroid medication for a long time. People with psoriatic diseases may also be more susceptible to developing pink eye, or conjunctivitis. According to a study in the journal Open Access Text, more than 64% of people suffering from psoriasis have conjunctivitis.
3. Psoriatic Inflammation & the Brain
Studies show that people suffering from psoriatic arthritis are more likely to experience anxiety and depression.
A survey revealed that over 36% of people with psoriatic arthritis had anxiety, and 22% had depression. These numbers are much higher than those with psoriasis.
Ritchlin states that patients with psoriaticarthritis have a dysmorphic view about themselves. This is a difficult disease to hide. It’s visible to others, but the patient can feel it.
Evidence is mounting that psoriatic inflammation can cause brain damage. Psoriatic arthritis is often associated with the presence of cytokines, which are inflammation proteins. They also appear in patients with depression.
“We used to believe inflammation was limited to joints and skin,” says Theoharis Theoharides MD, PhD, an immunologist at Tufts University School of Medicine, Boston. “The inflammation that is present in psoriatic joint disease is likely to be in the brain’s part that regulates mood. This is because psoriatic artifacts have a strong nervous system component.
RELATED: 6 Essential Sources for Psoriatic Arthritis Support
4. Pancreatitis and diabetes at higher risk
According to a study published in PLoS One, psoriatic diseases is associated with a higher risk of developing chronic pancreatitis. This is an inflammatory condition of the pancreas. Permanent damage to the pancreas can result from chronic pancreatitis.
Researchers found that chronic pancreatitis incidence was nearly twice as high in people suffering from psoriasis than it was in those who don’t have psoriasis. The researchers also found that patients with psoriasis who were taking nonsteroidal anti-inflammatory drug (NSAIDs), and methotrexate, commonly used for psoriatic arthritis treatment, had a lower chance of developing chronic pancreatitis.
Insulin is produced by the pancreas, which helps to maintain blood glucose levels. It can lead to diabetes mellitus type 1 and 2. Research shows that diabetes mellitus prevalence is higher among patients with psoriatic. Increased psoriatic activity was associated with a higher risk of developing diabetes.
In a review published in Rheumatology & Therapy, it was found that type 2 diabetes is more common in people with psoriatic than in the general population. According to the authors, certain treatments for psoriatic inflammation may have an impact on how blood sugar is maintained.
5. Psoriatic Disease and Fatty Liver
Ritchlin says that people suffering from psoriatic disease are more likely to have fatty liver disease.
A review of studies published in the Journal of Clinical and Aesthetic Dermatology revealed that as many as 47 percent of patients with psoriasis develop nonalcoholicfatty liver disease (NAFLD). This condition causes fatty deposits on the liver and can cause permanent scarring and damage. A study published in Gastroenterology Reviews found that patients suffering from psoriasis are more likely to develop NAFLD. It is also linked with the severity and duration of the disease.
Researchers think that inflammation caused by psoriatic disease may also have an impact on other parts of the body, such as the liver. People with psoriatic disease are also more likely to be overweight, diabetic, or metabolic syndrome. These are all risk factors for NAFLD.
Your liver can be affected by drugs used to treat psoriatic inflammation, such as NSAIDs or methotrexate. Your doctor will need to check your liver function if you are taking any of these drugs.
6. Jaw Pain and Psoriatic Arthritis
Psoriatic arthritis can affect any of the joints, even the temporomandibular (TMJ), which connects the jawbone and the skull. The masseter, which is the strongest muscle in your body and determined by its weight, links the TMJ to the masseter. The TMJ is susceptible to damage because it works so hard.
According to the National Psoriasis Foundation, about 35 percent of patients with psoriaticarthritis will experience symptoms in their TMJ.
Rheumatologists should perform a “66 to 68 joint count,” which measures swelling in 66 joints as well as tenderness and pain at 68 joints. TMJ damage is often overlooked by doctors.
Rheumatologists don’t always see the TMJ in clinical practice. They are part the 66-68 combined count, which was… endorsed as an obligatory measure for clinical trials, longitudinal studies,” Ana-Maria Orbai MD, assistant professor of rheumatology, Johns Hopkins University in Baltimore and a member of the NPF medical board, said to the National Psoriasis Foundation. “But most practitioners will only look at the hands of patients. Practitioners may not count all the joints correctly and miss the TMJ.
TMJ damage can be prevented or reduced by using biologics and MARDs (disease-modifying anti-rheumatic drug). To reduce jaw pressure, avoid hard foods and chewing them as much as possible.
7. Psoriatic Arthritis & Your Lungs
Psoriatic arthritis and inflammation can cause damage to your lungs, as well as increase the likelihood of developing chronic obstructive lung disease (COPD), which is a group of conditions that causes breathing problems.
Researchers concluded that people suffering from psoriasis have a higher risk of developing COPD in a review published by the Journal of Dermatological Treatment.
The risk of COPD in Taiwanese men and people over 50 years old with psoriasis was higher according to a Taiwanese study.
Researchers conducted a meta-analysis in the journal Allergy and Asthma Proceedings to examine the relationship between asthma and psoriasis in 66,772 patients with psoriasis and 577.415 controls. The risk of developing asthma in people with psoriasis was higher, particularly among older patients.
You might avoid smoking, dust, and lung irritants if you have psoriatic disease. This could increase your chance of developing COPD.
8. Digestive Disorders, and Psoriatic Arthritis
Did you know that psoriatic arthritis can also impact your gut health?
Clinical Rheumatology published a study that found people suffering from psoriatic inflammation are at greater risk of developing the following conditions.
Crohn’s disease is a chronic, inflammatory bowel disease that affects lining of the digestive system.
Ulcerative colitis is a chronic, inflammatory bowel disease that causes inflammation of the digestive tract.
Reflux esophagitis is a condition in which inflammation damages the esophageal lining.
Peptic ulcer disease is a condition that causes pain sores and ulcers in the stomach or small intestine.
A second study published in JAMA Dermatology found that people with psoriasis are approximately 2x more likely to develop Crohn’s or ulcerative colitis than the general population.
According to the authors, psoriasis was found to be significantly related with IBD. Patients with psoriasis may need to be referred for gastroenterology consultation if they have bowel symptoms.
Scientists think that gene mutations linked to psoriasis could also be associated with gut disorders.
