Plasma exchange in rheumatoid vasculitis.

Vasculitis is an uncommon, extremely debilitating complication of severe, chronic rheumatoid arthritis. High levels of circulating immune complexes along with vascular deposition of immunoglobulins and complement indicate an immune complex mediated disease. No pharmacologic therapy has been completely effective and the incidence of mortality is exceptionally high. This study shows clinical improvement with combination of plasma exchange and cytoxan therapy. We report an association in the conspicuous decline of immune complexes with objective clinical remission in 2 patients who underwent combination therapy. This adjunctive combination therapeutic modality is recommended in the treatment of rheumatoid vasculitis.