Kishore Shweta, Maher Lisa, Majithia Vikas
Division of Rheumatology, Department of Medicine, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA.
G. V. (Sonny) Montgomery VAMC, 1500 E. Woodrow Wilson Drive, Jackson, MS, 39216, USA.
Curr Rheumatol Rep. 2017 Jul;19(7):39. doi: 10.1007/s11926-017-0667-3.
Rheumatoid vasculitis (RV) is an unusual complication of long-standing rheumatoid arthritis, which is characterized by the development of necrotizing or leukocytoclastic vasculitis involving small or medium-sized vessels. In this review, we aim to provide an update on the epidemiology, pathogenesis, clinical presentation, and management of this challenging extra-articular manifestation.
RV is heterogenous in its clinical presentation depending on the organ and size of blood vessels involved. The most common organs involved are the skin and peripheral nerve. Based on recent population studies, the incidence has significantly decreased with early recognition and the advent of immunosuppressive drugs and biologics; however, the mortality rates remain high. RV remains a serious extra-articular manifestation of RA that needs to be promptly recognized and treated. No consensus is available on treatment, given the ongoing debate of whether the biologics can trigger or treat RV.
类风湿性血管炎（RV）是长期类风湿性关节炎的一种罕见并发症，其特征是出现累及小或中等大小血管的坏死性或白细胞破碎性血管炎。在本综述中，我们旨在提供关于这种具有挑战性的关节外表现的流行病学、发病机制、临床表现及管理方面的最新信息。
RV的临床表现因所累及的器官和血管大小而异。最常累及的器官是皮肤和周围神经。基于近期的人群研究，随着早期识别以及免疫抑制药物和生物制剂的出现，其发病率已显著下降；然而，死亡率仍然很高。RV仍然是类风湿性关节炎严重的关节外表现，需要及时识别和治疗。鉴于生物制剂能否引发或治疗RV仍存在争议，目前在治疗方面尚无共识。
