# A Case of Rheumatoid Arthritis in the Wake of Bereavement

## TL;DR

A woman developed rheumatoid arthritis shortly after experiencing the sudden death of her son, suggesting a link between acute psychological stress and autoimmune disease onset.

## Contribution

This case report highlights a potential causal relationship between acute grief and the onset of rheumatoid arthritis.

## Key findings

- A woman was diagnosed with rheumatoid arthritis months after experiencing the sudden death of her son.
- The case suggests a possible connection between acute psychological stress and autoimmune disease development.
- Integrated care and psychosocial evaluation are emphasized in managing autoimmune diseases.

## Abstract

Psychological stress, including bereavement and depression, can have immunological consequences that promote the development of autoimmune disease. Activation of the hypothalamic-pituitary axis (HPA) and sympathetic nervous system are potential mechanisms for crosstalk between emotional stress and immune system function. Studies have shown increased proinflammatory cytokines in individuals who experience major life stressors; these individuals are also at increased risk for developing autoimmune diseases, including rheumatoid arthritis. In this report, we present the case of a woman who presented to primary care after the sudden death of her son. She was found to be prediabetic with hyperlipidemia and, within several months of the acute psychological stressor, was diagnosed with rheumatoid arthritis (RA). Altogether, this new diagnosis of RA was likely triggered by grief, with a background of potential predisposing factors. This case illustrates a close temporal relationship between an acute stressor and onset of autoimmune disease. It underscores the importance of integrated care and psychosocial considerations in the evaluation and management of autoimmune diseases.