Systemic Rheumatoid Vasculitis: A Review

Marcia S. Genta, Robert M. Genta, Cem Gabay

Research output: Contribution to journalArticle

101 Citations (Scopus)

Abstract

Objectives: To review the most recent information on the incidence, clinical course, pathology, pathogenesis, diagnosis, and treatment of rheumatoid vasculitis (RV), including the still scanty data on the use of biologics. Methods: PubMed and MEDLINE databases (1950-2006) were searched for the key words "vasculitis" and "rheumatoid arthritis"; and "rheumatoid arthritis" and "extra-articular manifestations." All relevant articles in English and French were reviewed. Additional words used in follow-up research include "anti-TNF," "rituximab," "IL-1 receptor antagonists," and "CTLA-4 Ig," all in conjunction with "vasculitis." Pertinent secondary references were also retrieved. Results: RV is an inflammatory condition of the small- and medium-sized vessels that affects a subset of patients with established rheumatoid arthritis (RA) (∼1 to ∼5%). It has a vast array of clinical manifestations with a predilection for the skin (peripheral gangrene, deep cutaneous ulcers) and the peripheral nervous system (mononeuritis multiplex). Because of the lack of specific signs and symptoms, the diagnosis relies on the exclusion of other causes of similar lesions (diabetes, atherosclerosis, drug reactions, infection, neoplasias) and, ideally, on the histopathological demonstration of necrotizing vasculitis. Despite the availability of a host of promising new drugs for the treatment of RA, no clinical trials have tested their efficacy in RV; therefore, its management remains largely empirical. Conclusions: Although RV has apparently been decreasing over the last 2 decades, possibly as a consequence of the more energetic approach to the management of RA currently used, it remains an important complication of RA that needs to be promptly recognized and treated.

Original languageEnglish (US)
Pages (from-to)88-98
Number of pages11
JournalSeminars in Arthritis and Rheumatism
Volume36
Issue number2
DOIs
StatePublished - Oct 2006

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Rheumatoid Vasculitis
Systemic Vasculitis
Rheumatoid Arthritis
Vasculitis
Mononeuropathies
Skin Ulcer
Clinical Pathology
Gangrene
Interleukin-1 Receptors
Peripheral Nervous System
Biological Products
PubMed
MEDLINE
Pharmaceutical Preparations
Signs and Symptoms
Atherosclerosis
Joints
Clinical Trials
Databases
Skin

Keywords

  • extra-articular manifestations
  • rheumatoid arthritis
  • vasculitis

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Orthopedics and Sports Medicine
  • Rheumatology

Cite this

Systemic Rheumatoid Vasculitis : A Review. / Genta, Marcia S.; Genta, Robert M.; Gabay, Cem.

In: Seminars in Arthritis and Rheumatism, Vol. 36, No. 2, 10.2006, p. 88-98.

Research output: Contribution to journalArticle

Genta, Marcia S. ; Genta, Robert M. ; Gabay, Cem. / Systemic Rheumatoid Vasculitis : A Review. In: Seminars in Arthritis and Rheumatism. 2006 ; Vol. 36, No. 2. pp. 88-98.
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