Olivé Alejandro, Riveros Anne, Juárez Pablo, Morales-Ivorra Isabel, Holgado Susana, Narváez Javier
Servicio de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), España.
Servicio de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), España.
Med Clin (Barc). 2020 Aug 14;155(3):126-129. doi: 10.1016/j.medcli.2020.01.024. Epub 2020 Mar 5.
To describe the clinical manifestations, evolution and treatment of patients with rheumatoid vasculitis.
Retrospective study (1975-2017) of all patients diagnosed with rheumatoid vasculitis in 2 Rheumatology Services.
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 rheumatoid vasculitis 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 2years 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.
The clinical manifestations of rheumatoid vasculitis were similar to previous studies. The frequency of rheumatoid vasculitis seems to decrease. However, the clinical picture and severity remains invariable.
描述类风湿性血管炎患者的临床表现、病情演变及治疗情况。
对两家风湿病科诊断为类风湿性血管炎的所有患者进行回顾性研究(1975 - 2017年)。
共纳入41例患者,男性17例(41.5%),女性24例(58.5%);诊断时的平均年龄:67±9岁;类风湿关节炎病程:10±8.3年。大多数患者有侵蚀性病变,33例(80%)。所有患者类风湿因子和抗瓜氨酸化抗体均为阳性。30例(73%)患者有全身症状,17例(41%)患者有关节外表现。类风湿性血管炎的临床表现主要为:皮肤病变28例(68%),多发性神经炎26例(63%)。所有患者均接受糖皮质激素治疗。24例(58.5%)患者联合使用了免疫抑制剂。5例(12%)患者接受了糖皮质激素与生物治疗联合治疗。随访2年后的死亡率为33%,最常见的原因是感染和血管炎进展。在过去十年中,类风湿性血管炎的发病率有所下降。
类风湿性血管炎的临床表现与以往研究相似。类风湿性血管炎的发病率似乎在下降。然而,临床表现和严重程度仍然不变。