TY - JOUR
T1 - Rheumatoid vasculitis
T2 - Experience with 13 patients and review of the literature
AU - Schneider, Howard A.
AU - Yonker, Richard A.
AU - Katz, Paul
AU - Longley, Seiden
AU - Panush, Richard S.
N1 - Funding Information:
From the Division of Clinical Immunology, Departmenr of Medicine, University of Florida, and Medical and Research Services, Veterans Administration Medical C’enter. Gainesville. Howard A. Schneider, MD: Postdocroral Fellow. Division of Clinical Immunology; Richard A. Yonker, DO: Posrdw-toral Fellow, Division of Clinical Immunology; Paul Katl, MD: Assistant Professor of Medicine and Immunology and Medical Microbiology, Division of Clinical Immunology: Selden Longley, MD: Associate Professor of Medicine, Division of Clinical Immunology; and Richard S. Panush. MD: Associate Professor of Medicine and Immunology and Medical Microbiology, and Chief. Division of Clinical Immunology, Department of Medicine, College of Medicine, University of Florida, Gainesville. Supported in part by the Veterans Administration and the Florida Chapter of the Arthritis Foundation. Address reprint requests to Richard S. Panush. MD, Department of Medicine, Box J-277, JHMHC. University of Florida, Gainesville, FL 326 IO. (r 1985 by Grune & Stratton, Inc. 0049~0172/85/1404-0007$3.00/O
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1985/5
Y1 - 1985/5
N2 - Rheumatoid vasculitis is an uncommon but potentially catastrophic complication of RA. There are few current extensive experiences and no consensus regarding the clinical, laboratory, histologic features, and management or prognosis of rheumatoid vasculitis. We therefore reviewed selected observations in 13 patients followed over the past decade and compared them with patients reported and with results of a survey of North American Rheumatologists. Our patients were seven men and six women (age, 33 to 70 years) who had had active RA for 4 to 36 years. They exhibited sensory neuropathy, mononeuritis multiplex, Felty syndrome, cutaneous lesions, leg ulcers, gangrene, anemia, leukocytosis, eosinophilia, high titers of RF, hypocomplementemia, and CICs or cryoglobulinemia approximately as frequently as other reported patients with rheumatoid vasculitis, but they displayed constitutional symptoms, subcutaneous nodules, ischemic changes, and proteinuria rather less consistently than in other series. These observations were not necessarily as expected by survey respondents. We, as in other series and suggested by survey respondents, tended to select penicillamine or cytotoxic drugs (or plasmapheresis) for patients with mononeuritis, gangrene, or leg ulcers, and nonsteroidal antiinflammatory drugs, antimalarials, gold, or penicillamine for sensory neuropathy or digital lesions. Four patients died, two deteriorated, and seven were stable or improved, a finding that was also similar to the experiences of others. Rheumatoid vasculitis is an uncommon, potentially catastrophic syndrome with varying clinicopathologic features that have different prognostic implications and should be managed individually.
AB - Rheumatoid vasculitis is an uncommon but potentially catastrophic complication of RA. There are few current extensive experiences and no consensus regarding the clinical, laboratory, histologic features, and management or prognosis of rheumatoid vasculitis. We therefore reviewed selected observations in 13 patients followed over the past decade and compared them with patients reported and with results of a survey of North American Rheumatologists. Our patients were seven men and six women (age, 33 to 70 years) who had had active RA for 4 to 36 years. They exhibited sensory neuropathy, mononeuritis multiplex, Felty syndrome, cutaneous lesions, leg ulcers, gangrene, anemia, leukocytosis, eosinophilia, high titers of RF, hypocomplementemia, and CICs or cryoglobulinemia approximately as frequently as other reported patients with rheumatoid vasculitis, but they displayed constitutional symptoms, subcutaneous nodules, ischemic changes, and proteinuria rather less consistently than in other series. These observations were not necessarily as expected by survey respondents. We, as in other series and suggested by survey respondents, tended to select penicillamine or cytotoxic drugs (or plasmapheresis) for patients with mononeuritis, gangrene, or leg ulcers, and nonsteroidal antiinflammatory drugs, antimalarials, gold, or penicillamine for sensory neuropathy or digital lesions. Four patients died, two deteriorated, and seven were stable or improved, a finding that was also similar to the experiences of others. Rheumatoid vasculitis is an uncommon, potentially catastrophic syndrome with varying clinicopathologic features that have different prognostic implications and should be managed individually.
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U2 - 10.1016/0049-0172(85)90047-2
DO - 10.1016/0049-0172(85)90047-2
M3 - Review article
C2 - 3909408
AN - SCOPUS:0021876846
VL - 14
SP - 280
EP - 286
JO - Seminars in Arthritis and Rheumatism
JF - Seminars in Arthritis and Rheumatism
SN - 0049-0172
IS - 4
ER -