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An arm and a leg: A case of rheumatoid vasculitis and antiphospholipid antibody syndrome

Rheumatoid vasculitis is a rare extra-articular complication of rheumatoid arthritis. The most common manifestation is cutaneous; however, it can manifest in various organ systems and is associated with a high degree of morbidity and mortality. Diagnosis is challenging, and there are no validated di...

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Autores principales: Ghadiali, Jay, Talwar, Aditya, Ligon, Colin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141980/
https://www.ncbi.nlm.nih.gov/pubmed/34094564
http://dx.doi.org/10.1177/2050313X211015895
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author Ghadiali, Jay
Talwar, Aditya
Ligon, Colin
author_facet Ghadiali, Jay
Talwar, Aditya
Ligon, Colin
author_sort Ghadiali, Jay
collection PubMed
description Rheumatoid vasculitis is a rare extra-articular complication of rheumatoid arthritis. The most common manifestation is cutaneous; however, it can manifest in various organ systems and is associated with a high degree of morbidity and mortality. Diagnosis is challenging, and there are no validated diagnostic or classification criteria. Most cases should be confirmed with tissue biopsy when possible given the severity of disease and the extent of immunosuppression required to treat this condition. We report the case of a 54-year-old white woman with long-standing, uncontrolled, and seropositive rheumatoid arthritis with a history of elevated anticardiolipin IgG and IgM antibodies who presented with acute stenosis of her left femoral artery which ultimately required a left above-the-knee amputation. Histopathology revealed findings consistent with vasculitis and thrombosis, and subsequent imaging revealed multifocal arterial and venous thromboses. She was diagnosed with rheumatoid vasculitis and antiphospholipid antibody syndrome, and was treated with high-dose glucocorticoids, cyclophosphamide, and warfarin. Rheumatoid vasculitis is a rare but devastating complication of rheumatoid arthritis, and vigilance for this condition must be maintained, especially in patients with long-standing, seropositive disease.
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spelling pubmed-81419802021-06-04 An arm and a leg: A case of rheumatoid vasculitis and antiphospholipid antibody syndrome Ghadiali, Jay Talwar, Aditya Ligon, Colin SAGE Open Med Case Rep Case Report Rheumatoid vasculitis is a rare extra-articular complication of rheumatoid arthritis. The most common manifestation is cutaneous; however, it can manifest in various organ systems and is associated with a high degree of morbidity and mortality. Diagnosis is challenging, and there are no validated diagnostic or classification criteria. Most cases should be confirmed with tissue biopsy when possible given the severity of disease and the extent of immunosuppression required to treat this condition. We report the case of a 54-year-old white woman with long-standing, uncontrolled, and seropositive rheumatoid arthritis with a history of elevated anticardiolipin IgG and IgM antibodies who presented with acute stenosis of her left femoral artery which ultimately required a left above-the-knee amputation. Histopathology revealed findings consistent with vasculitis and thrombosis, and subsequent imaging revealed multifocal arterial and venous thromboses. She was diagnosed with rheumatoid vasculitis and antiphospholipid antibody syndrome, and was treated with high-dose glucocorticoids, cyclophosphamide, and warfarin. Rheumatoid vasculitis is a rare but devastating complication of rheumatoid arthritis, and vigilance for this condition must be maintained, especially in patients with long-standing, seropositive disease. SAGE Publications 2021-05-20 /pmc/articles/PMC8141980/ /pubmed/34094564 http://dx.doi.org/10.1177/2050313X211015895 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Ghadiali, Jay
Talwar, Aditya
Ligon, Colin
An arm and a leg: A case of rheumatoid vasculitis and antiphospholipid antibody syndrome
title An arm and a leg: A case of rheumatoid vasculitis and antiphospholipid antibody syndrome
title_full An arm and a leg: A case of rheumatoid vasculitis and antiphospholipid antibody syndrome
title_fullStr An arm and a leg: A case of rheumatoid vasculitis and antiphospholipid antibody syndrome
title_full_unstemmed An arm and a leg: A case of rheumatoid vasculitis and antiphospholipid antibody syndrome
title_short An arm and a leg: A case of rheumatoid vasculitis and antiphospholipid antibody syndrome
title_sort arm and a leg: a case of rheumatoid vasculitis and antiphospholipid antibody syndrome
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141980/
https://www.ncbi.nlm.nih.gov/pubmed/34094564
http://dx.doi.org/10.1177/2050313X211015895
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