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Arteropathies, Microcirculation and Vasculitis
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
Rheumatoid vasculitis is an inflammatory process that is now recognized to primarily affect small- to medium-sized blood vessels, is highly heterogenous clinically, can present with widespread organ involvement and is associated with a dire prognosis. Rheumatoid vasculitis can affect many different organs, including the eyes, skin, hands and feet. It commonly occurs in patients who have severe RA.
Diseases of the Peripheral Nerve and Mononeuropathies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Diana Mnatsakanova, Charles K. Abrams
Rheumatoid vasculitis occurs as a late manifestation of severe seropositive disease. With advancements in effective treatment, this is declining in incidence. Many patients with rheumatoid arthritis develop a mild, symmetrical polyneuropathy, which is distinct from vasculitic neuropathy. Median mononeuropathy at the wrist (carpal tunnel syndrome) and other compressive neuropathies are quite common.
Wound healing and ulcers
Published in Ronald Marks, Richard Motley, Common Skin Diseases, 2019
Ulcers may develop in the course of a disorder in which small blood vessels become inflamed and thrombosed (vasculitis). Rheumatoid vasculitis is one such condition in which ulceration may occur. Ulcers often occur on the legs (Fig. 13.11), but may develop anywhere. They may start from a patch of purpura. Treatment is directed towards the underlying illness.
Current perspectives on the diagnosis, assessment, and management of vasculitic neuropathy
Published in Expert Review of Neurotherapeutics, 2022
Yuki Fukami, Haruki Koike, Masahisa Katsuno
Secondary systemic vasculitides are a heterogeneous group including vasculitis associated with infections, connective tissue diseases, malignancies, inflammatory bowel disease, hypocomplementemic urticarial vasculitis syndrome, and drug-induced vasculitis [5]. Vasculitic neuropathy can be associated with systemic rheumatic diseases. RA is complicated by rheumatoid vasculitis (RV) in 20–40% of patients [1,37]. Moreover, approximately 40% of patients with RV have sensory neuropathy, and up to 20% develop mixed symptoms of motor and sensory neuropathy [1]. In SLE, vasculitic mono- and multiple neuropathies tend to present acutely or subacutely with painful sensory and motor dysfunction [38]. It is estimated that 10–20% of patients with SLE have peripheral nervous system involvement [39], and mononeuritis multiplex occurs in 3% of 102 primary Sjögren’s syndrome patients [40]. According to a study involving 92 patients with neuropathy associated with Sjögren’s syndrome, 11 manifested mononeuritis multiplex and were presumed to have vasculitis [28]. Even if peripheral neuropathy is rare in sarcoidosis, epineural and perineural granulomas and granulomatous vasculitis can cause ischemic axonal degeneration and demyelination due to local pressure [41]. Cryoglobulinemia is a secondary vasculitis caused by deposition of circulating cryoglobulins, causing peripheral neuropathy in up to 60% of patients with mixed cryoglobulinemia syndrome, often associated with hepatitis C, hepatitis B, or human immunodeficiency virus infection [42].
COVID-19 infection and rheumatoid arthritis: mutual outburst cytokines and remedies
Published in Current Medical Research and Opinion, 2021
Noha Mousaad Elemam, Azzam A. Maghazachi, Suad Hannawi
Another common feature among RA and COVID-19 infection is vasculitis. Systemic rheumatoid vasculitis is among the most serious complications of RA. It is characterized by inflammation of mid-size arteries and capillaries, which could lead to deep cutaneous ulcers, gangrene, and neuropathy, which is associated with poor outcomes and mortality68. Recently, some case reports highlighted the presence and association of vasculitis in COVID-19 patients69,70. Also, the development of RA is accompanied by a disturbance of the coagulation system and elevation in the blood coagulation state and fibrinolysis, which is probably due to excessive stimulation of inflammatory pathways71,72. Likewise, coagulopathies were observed in COVID-19 infection as reported by the prominent elevation of D-dimer and fibrin/fibrinogen-degradation products. This was proposed to be a result of the hypoxia and the inflammatory response to SARS-CoV-2 causing thrombo-inflammation and thrombosis73.
Simultaneous development of IgA vasculitis and eosinophilic granulomatosis with polyangiitis
Published in Modern Rheumatology Case Reports, 2020
Yosuke Asano, Yoshinori Matsumoto, Tatsuhiko Miyazaki, Akihiro Ishizu, Shin Morizane, Keigo Hayashi, Yuriko Yamamura, Sumie Hiramatsu, Yoshia Miyawaki, Michiko Morishita, Keiji Ohashi, Haruki Watanabe, Katsue Sunahori Watanabe, Tomoko Kawabata, Ken-Ei Sada, Hirofumi Makino, Jun Wada
We consider the possibility of rheumatoid vasculitis as a differential diagnosis. Although she had achieved complete remission of rheumatoid arthritis, we observed joint destruction of her both wrists in addition to the elevated RF and CARF levels, suggesting previous active arthritis. In addition to the histological features, clinical manifestations of purpura and mononeuritis multiplex without present active arthritis, pleuritis and hypocomplementaemia suggest concurrent development of IgAV and EGPA rather than rheumatoid vasculitis. These findings fulfil the Chapel Hill classification criteria for IgAV and EGPA described previously [2]. Our present case indicates that histological examination of the skin from purpuric lesions is required to distinguish small vessel vasculitis.