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Inicio Medicina Clínica (English Edition) Rheumatoid vasculitis: study of 41 cases
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Vol. 155. Issue 3.
Pages 126-129 (August 2020)
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Vol. 155. Issue 3.
Pages 126-129 (August 2020)
Clinical report
DOI: 10.1016/j.medcle.2020.01.010
Rheumatoid vasculitis: study of 41 cases
Vasculitis reumatoide: estudio de 41 casos
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Alejandro Olivéa,
Corresponding author
aolive.germanstrias@gencat.cat

Corresponding author.
, Anne Riverosa, Pablo Juárezb, Isabel Morales-Ivorrab, Susana Holgadoa, Javier Narváezb
a Servicio de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), Spain
b Servicio de Reumatología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
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Tables (3)
Table 1. Scott and Bacon criteria.
Table 2. Demographic, clinical-laboratory data and treatments of the 41 patients with rheumatoid vasculitis.
Table 3. Comparative study between deceased and surviving patients (only patients for whom long-term follow-up data are available are included: N = 36).
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Abstract
Aim

To describe the clinical manifestations, evolution and treatment of patients with rheumatoid vasculitis.

Methods

Retrospective study (1975–2017) of all patients diagnosed with RV in 2 Rheumatology Services.

Results

A total of 41 patients were included, 17 (41.5%) males and 24 (58.5%) females; mean age at diagnosis: 67 ± 9 years; duration of rheumatoid arthritis: 10 ± 8.3 years.

Most patients had erosive disease, 33 (80%). Rheumatoid factor and anticitrullinated antibodies were positive in all patients. Constitutional symptoms were present in 30 (73%) patients and extra-articular manifestations in 17 (41%) patients. The clinical manifestations of RV were mainly: cutaneous 28 (68%), and polyneuritis 26 (63%).

All patients were treated with glucocorticoids. An immunosuppressant was associated in 24 (58.5%) patients. Five (12%) patients were treated with the association of glucocorticoids and a biologic treatment. The mortality after 2 years of follow-up was 33%, the most common causes being infection and progression of the vasculitis. The frequency of rheumatoid vasculitis has decreased over the last decade.

Conclusion

The clinical manifestations of RV were similar to previous studies. The frequency of RV seems to decrease. However, the clinical picture and severity remains invariable.

Keywords:
Rheumatoid vasculitis
Rheumatoid arthritis
Resumen
Objetivo

Analizar las características clínicas, tratamiento y evolución de la vasculitis reumatoide.

Métodos

Estudio retrospectivo (1975-2017). Pacientes con vasculitis reumatoide diagnosticados en 2 servicios de reumatología.

Resultados

Se incluyó a 41 pacientes: 17 (41,5%) varones y 24 (58,5%) mujeres; con una edad media al diagnóstico de 67 ± 9 años y una duración de la artritis reumatoide de 10 ± 8,3 años. La artritis fue erosiva en 33 (80%) pacientes. Tanto el factor reumatoide como los anticuerpos antipéptido citrulinados fueron positivos en todos los casos. Los síntomas constitucionales se presentaron en 30 pacientes (73%) y las manifestaciones extrarticulares en 17 (41%). Las manifestaciones clínicas más frecuentes fueron: cutáneas 28 (68%) y neuropatía periférica 26 (63%).

Todos los pacientes fueron tratados con glucocorticoides. En 24 pacientes (58%) se asoció a un inmunosupresor y 5 (12%) pacientes fueron tratados con fármacos biológicos.

La mortalidad a los 2 años de seguimiento fue del 33%. Las principales causas de muerte fueron: la infección y la progresión de la vasculitis reumatoide. La frecuencia de la vasculitis reumatoide disminuyó en la última década.

Conclusiones

Las manifestaciones clínicas de la vasculitis reumatoide en España son similares a las descritas. La frecuencia disminuye; sin embargo, el cuadro clínico y la gravedad se mantienen invariables.

Palabras clave:
Vasculitis reumatoide
Artritis reumatoide

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