Necrotizing vasculitis as the initial manifestation of rheumatoid arthritis
Gray, R.G.; Poppo, M.J.
Journal of Rheumatology 10(2): 326-328
1983
ISSN/ISBN: 0315-162X PMID: 6864690 Document Number: 218635
A 64-year-old Black woman presented with high titer serum rheumatoid factor (RF), pelvic girdle weakness, sensory mononeuropathy, pulmonary fibrosis, and muscle histologic evidence of small artery necrotizing vasculitis. High dose corticosteroid therapy was followed by clinical improvement and reduction in serum RF titer. Four years later, and 9 months after discontinuance of corticosteroids, she developed an inflammatory polyarthritis, recurrent muscle weakness, and left foot drop, concomitantly with circulating immune complexes and extremely high titer serum RF. Necrotizing vasculitis is a distinctly rare presenting manifestation of rheumatoid disease.