Fana Michael, Chao Shing, Katramados Angelos M
Department of Neurology, Henry Ford Health System, Detroit, MI, USA.
Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA.
Clin Neurol Neurosurg. 2022 Apr;215:107199. doi: 10.1016/j.clineuro.2022.107199. Epub 2022 Mar 4.
Rheumatoid arthritis (RA) is an autoimmune disorder which manifests as inflammation of the synovial joints alongside extra-articular involvement. Uncommonly, patients may develop vasculitis of small and medium-sized blood vessels, formally diagnosed as systemic rheumatoid vasculitis (SRV). In particularly rare cases, patients may develop a subtype of SRV known as cerebral rheumatoid vasculitis (CRV) which manifests in patients as stroke. To date, no formal recommendations or guidelines have been established for treatment and prevention of CRV-induced stroke besides experiential therapy with various immunomodulators. Here, we describe the utility of Rituximab in addition to steroids for prevention of stroke in our patient with evidence of multiple CRV-induced strokes with excellent recovery of post-stroke symptoms and remission of new onset cerebral vasculitis processes.
类风湿性关节炎（RA）是一种自身免疫性疾病，表现为滑膜关节炎症并伴有关节外受累。罕见的情况下，患者可能会发展为中小血管血管炎，正式诊断为系统性类风湿性血管炎（SRV）。在极为罕见的病例中，患者可能会发展为SRV的一种亚型，称为脑类风湿性血管炎（CRV），其在患者中表现为中风。迄今为止，除了使用各种免疫调节剂进行经验性治疗外，尚未建立针对CRV所致中风的治疗和预防的正式建议或指南。在此，我们描述了利妥昔单抗联合类固醇在预防我们这位患者中风方面的效用，该患者有多次CRV所致中风的证据，中风后症状得到了极佳恢复，新发脑血管炎过程也得到缓解。
