I'm sure you can find statistics but I believe the most affected are the lungs (lung nodules) and the heart (because it is encased in a lining the RA can attack)....

Are you wondering about the liver?
Did your wife get a biopsy? I am diagnosed with fatty liver. Mine could have been before RA or it could have been caused by methotrexate. But my liver numbers are normal. It was the biopsy that found the extra fat in the cells.
The liver can get it's own autoimmune disease separate from others - and the biopsy tells the tale on it too.

I've not heard much of other organs involved. Mostly lungs.
I'm curious about the sulfasalazine for your wife after she quits breastfeeding. My liver doctor said no to it because it could raise enzymes. My enzymes are typically 20 AST and 25 ALT, but the Enbrel put them up in the 200s and the combo Enbrel/methotrexate put them into the 500s.

I'm all for any help we can get for the RA!

Thanks Sally! Very helpful!


BCatz, she is getting an ultrasound soon and they are giving her a month with vitamins and a weight loss trial to see if Enzymes decrease(slightly elevated). If enzymes remain the same, she will be getting a liver biopsy. I will ask more about the sulfasalazine. The doctor mentioned it doesn't affect the liver. So I will ask once again.

My wife is stuck in a hard place. Her RA doctor wants to treat agrressively but her enzymes are up and biologics are out of the question because she has latent TB. Treatment for latent TB is currently not recommended because of the liver enzymes.

Most drugs can injure the liver. I was super "lucky" in that Enbrel, one of the RAREST ever to injure he liver, did so. I say injure, it elevated enzymes and was caught very fast. That's the great thing - you can take a chance on a medication (not biologic in your wife's case) and get enzymes checked frequently.
Here is the site I use for liver toxicity. Most drugs have some liver interaction so don't be alarmed...but as you look through, you will find better dmard choices overall to try.
As insulting as Methotrexate is to the liver, my enzymes rose from the low 20s to the low 30s on a rather high dose and stayed there for 6 months. It was the addition of Enbrel that hijacked them. So if I get "desperate" I could retry methotrexate at a very low dose and see where it takes me.

http://livertox.nih.gov
if the link doesn't work, just find livertox.nih.gov

I just read on sulfasalazine. Perhaps the doctor was comparing it to MTX, when she talked about it not damaging the liver.

Good to hear Jen.

It seems like everyone moves on to biologics. Me and my wife thought Plaquenil would be it. It turns out the doctor went the safe route because of the liver enzymes and my wife is still breastfeeding.

it was the frequent IV and oral antibiotics (pneumonias) and nsaids that did me in once upon a time, not the mtx or the biologics.

i am happiest when I do not have to take the antibiotics and I am happy to say I am back to the below 20's also bcatz

its funny how our bodies are all different.

depot

I'm another one with organ damage which may have been caused by the disease itself or the RA meds but who knows for sure. Very fortunately, in August, 2015, my Rheumatologist (who self-describes himself as a "worry wart") decided to do a Whole body CT Scan, Nuclear Bone Scan and MRI to find reason for constant pain in both legs.
The CT scan, followed by a PET Scan showed up a small lesion on my right lung which was needle biopsied and turned out to be cancerous.
The good news was that it was found at a very early stage, by sheer chance. So, I had the whole top lobe of the right lung taken. The right lung has 3 lobes, I learnt, whilst the left lung has only two lobes. The operation was on Sept 26 (actually, my husband's birthday).
The great news was that the cancer was contained inside that lobe and there was no lymph gland involvement so no other treatment, as in chemo or radiation, had to be done.
.Just proves again that you never know what is around the corner. I feel blessed that my Rheumy is so thorough because I had no symptoms at all. I could have done without this nasty surprise but still can't believe how lucky I was and that's what I'm focusing on.
You know when you take these heavy duty drugs with dire warnings what can happen but hope it won't be you.
My Rheumatologist does blood tests every four weeks re Methotrexate affecting liver.
I had been on Orencia for 12 months previous to Actemra at the time of diagnosis. (Interesting to read your post re Orencia, Jen)
Eight weeks after the surgery, I had 2 Rituxin infusions which, virtually wiped out my immune system.and this resulted in Shingles and Cellulitis. I have been off all meds since beginning of May and about to go back onto Methotrexate this weekend.
It is fairly rare that organs are attacked but it does happen...

One organ not mentioned here is the brain. RA brain fog is when the disease attacks the brain.

I actually had this as my first symptom. It took years to put together that not being able to think, plan and remember were actually part of the disease.

I was in school when it first happened, taking a French vocabulary course. I tried for weeks to remember the words and definitions, and I could not remember any of the 500 words. Then I had an asthma attack and had to go on 40 mg of prednisone. I had 2 days left till the exam, and I was able to memorize all 500 words and pull off an A! I would have flunked before the prednisone.

After I had RA, when I had a med failure, I always noticed this inability to put 2 and 2 together. But prednisone or a good working biologic brought back my brain to working order.

I'm not sure how much long term damage my brain gets. I did very well in my Master's degree program, when I was on good meds. I'd like to do a Ph.D, but I can't find a good drug so that dream is going to have to wait, or be never.