Rheumatoid Arthritis and Fevers: What Is the Connection?

A low grade fever is a common symptom of living with rheumatoid arthritis. Read on to find out causes, symptoms, and possible treatments.

Rheumatoid arthritis (RA) is an autoimmune disease that primarily affects the small joints of the hands, wrists, feet, and ankles. It can also have some systemic (whole-body) symptoms, including a fever.

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Can RA cause fevers?

RA-related fever is an elevation in body temperature above 100.4°F (38°C) that lasts for an extended period of time.

Typically, RA-related fevers remain in the low grade range, between 99°F (37.2°C) to 100.4°F (38°C). Some people do report longer-lasting higher temperature readings.

RA-related fevers are usually caused by the underlying autoimmune disease, but there are a couple of different reasons the fever might occur:

1. Inflammation: RA can sometimes cause systemic inflammation. The body’s immune response can include a fever.
2. Infection: Living with RA can mean you have a compromised immune system and are more prone to infections. Fever can be the first sign of an infection. Additionally, many of the medications used to treat RA, such as disease-modifying antirheumatic drugs (DMARDs) and biologics, cause an immunocompromised state, which can also make one more susceptible to infections.

Is RA-related fever different from other fevers?

An RA-related fever is different from other kinds of fevers because of its underlying cause. You cannot have an RA-related fever unless you have RA.

RA-related fever is usually low grade, ranging from 99°F (37.2°C) to 100.4°F (38°C), over an extended period of time, usually weeks to months. Fevers from other causes typically have a rapid onset and resolve in a much shorter period of time, usually days to a week.

In addition to fevers, you’ll usually have traditional symptoms of RA such as joint pain, stiffness, swelling, fatigue, and limited mobility. Someone with RA may also report a flare in their symptoms at the time of the fever.

Fevers from other causes will be accompanied by symptoms typical of that problem. For example, pneumonia may cause a fever, and you would most likely have a cough and shortness of breath.

How do you treat RA-related fevers?

Treatment of RA-related fevers will depend on trying to decipher the underlying cause. While related to RA, determining whether it’s due to inflammation or infection from suppressed immunity will help to tailor treatment.

It’s important to consult with your doctor prior to starting any treatment. They will likely do the following:

• Check your vital signs.
• Review your symptoms in detail.
• Perform a physical exam.
• Order any additional tests.

If related to systemic inflammation, the RA-related fevers may respond to medications and other treatments directed at controlling the underlying RA symptoms. Managing inflammation may involve changing, stopping, or adjusting the dosages of your RA medications in combination with other lifestyle modifications.

For example, this review suggests that a healthy diet, avoiding obesity and smoking, and frequent physical activity can effectively support treatment outcomes.

You might have a fever from an infection due to being immunocompromised with RA. If this is the case, you may require antibiotics or antivirals to bring down the fevers.

Symptom management is also an important treatment consideration. This may include the use of medications to lower the fever such as aspirin, ibuprofen, naproxen, or other nonsteroidal anti-inflammatory drugs (NSAIDs). You should talk with your doctor before taking these treatments and familiarize yourself with the side effects and possible medication interactions.

If you’re taking NSAIDs or corticosteroids to manage what you feel is an RA-related fever, and you’re still having measurable temperatures over 99°F (37.2°C), you should seek medical attention as soon as possible. These medications are very effective at lowering body temperatures, so a persistent fever while taking them could be a sign of something more serious.

FAQs

Is RA-related fever the same as rheumatic fever?

RA-related fever is not the same as rheumatic fever. RA-related fevers are associated with the underlying condition of RA. Rheumatic fever is a complication of untreated (or incompletely treated) streptococcal throat infections caused by Group A Streptococcus bacteria. Learn more about rheumatic fever here.

Why do I keep getting fevers with RA?

Typically, RA-related fevers are due to poorly controlled RA with high disease activity and inflammation. Managing these symptoms and inflammation is a more general approach to the treatment of RA-related fevers.

If fevers are an ongoing or recurring issue, you might want to monitor your own health status day-to-day. Keeping a symptom log or using a symptom tracker app is especially helpful for this. It may help you or your doctor figure out a cause and treatment for your fevers.

The takeaway

If you have RA, a fever may be a sign of an underlying infection or worsening inflammation somewhere in your body. It can be a common symptom of RA, but you should talk with your doctor right away.

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