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Romanian Journal of Internal Medicine

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New insight into the rheumatoid vasculitis

M. Cojocaru
  • Corresponding author
  • “Titu Maiorescu” University, Faculty of Medicine, Bucharest
  • “Dr. Ion Stoia” Clinical Center for Rheumatic Diseases, Bucharest
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Inimioara Mihaela Cojocaru
  • “Carol Davila” University of Medicine and Pharmacy, Bucharest
  • Department of Neurology, “Colentina” Clinical Hospital, Bucharest, Romania
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ B. Chicoş
Published Online: 2015-10-14 | DOI: https://doi.org/10.1515/rjim-2015-0017

Abstract

Vasculitis in rheumatoid arthritis (rheumatoid vasculitis, RV) has a heterogeneous clinical presentation that includes skin disorders, neuropathy, eye symptoms and systemic inflammation. Rheumatoid vasculitis is an unusual complication of longstanding, severe rheumatoid arthritis (RA).

While RA affects the body’s joints, vasculitis is a condition in which blood vessels become inflamed. Rheumatoid vasculitis occurs in approximately 2 to 5% of patients who have RA. The blood vessels most often involved are arteries that bring blood to the skin, nerves, and internal organs. Veins can also be involved. Rheumatoid vasculitis is skin condition that is a typical feature of RA, presenting as peripheral vascular lesions that are localized (purpura, cutaneous ulceration, and gangrene of the distal parts of the extremities). The cause of RV is unknown, but given the prominence of immune components and the pathologic changes in involved blood vessels, an autoimmune process is suggested. Compared to other forms of vasculitis, there has been relatively little research in recent years on the specific entity of RV. There is some evidence that the incidence of RV has decreased over the past several decades, perhaps because of a better treatment of the underlying RA. In the present review, we discuss the clinical features, laboratory tests, the pathogenesis of RV.

Vasculita din cadrul poliartritei reumatoide (PR) se prezintă clinic polimorf, cuprinde modificări cutanate, neuropatie, simptome oculare şi inflamaţie sistemică. Vasculita reumatoidă (VR) este o complicaţie neobişnuită a PR severe cu evoluţie îndelungată. În timp ce PR afectează articulaţiile, vasculita este o stare în care vasele sanguine sunt inflamate. Vasculita reumatoidă se întâlneşte la aproximativ 2-5% dintre pacienţii cu PR. Vasele sanguine cel mai adesea afectate sunt arterele care vascularizează pielea, nervii şi organele interne. Venele pot, de asemenea, să fie afectate. Vasculita reumatoidă este modificarea cutanată tipică în PR, se prezintă cu leziuni vasculare periferice care sunt localizate (purpura, ulceraţii cutanate, gangrena extremităţilor). Cauza VR este deocamdată neelucidată, din cauza prezenţei componentelor imune şi modificărilor patologice la nivelul vaselor sanguine afectate s-a sugerat un proces autoimun. Comparativ cu alte forme de vasculite, există puţine cercetări în ultimii ani referitoare la VR. Unele rapoarte evidenţiază că incidenţa VR a scăzut în ultimele decade datorită tratamentului eficient în PR. În acest referat, autorii discută despre trăsăturile clinice, patogenia şi testele de laborator în VR.

Keywords: rheumatoid vasculitis; clinical features; laboratory tests; pathogenesis

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About the article

Published Online: 2015-10-14

Published in Print: 2015-06-01


Citation Information: Romanian Journal Of Internal Medicine, Volume 53, Issue 2, Pages 128–132, ISSN (Online) 1220-4749, DOI: https://doi.org/10.1515/rjim-2015-0017.

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© 2015 M. Cojocaru et al., published by De Gruyter Open. This chapter is distributed under the terms of the Creative Commons Attribution 4.0 Public License. BY 4.0

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