Factors associated with the development of vasculitis in rheumatoid arthritis: results of a case-control study.
OBJECTIVE
To investigate those characteristics of patients with rheumatoid arthritis (RA) that are associated with the development of rheumatoid vasculitis (RV).


METHODS
Demographic and clinical data of 69 patients who had been diagnosed as having RV were compared with those of 138 contemporaneous control patients with RA who were not suspected to have vasculitis. Vasculitis was confirmed histologically in 96% of the subjects with RV.


RESULTS
Variables associated with the development of RV were: 1) male gender, presence of increased serum concentrations of rheumatoid factor, joint erosions, subcutaneous nodules, number of disease modifying antirheumatic drugs previously prescribed, treatment (ever) with D-penicillamine or azathioprine; 2) presence of nail fold lesions and any other extrarticular feature one year before the time of diagnosis of RV; 3) treatment with corticosteroids at the time of diagnosis of RV.


CONCLUSIONS
The development of RV is associated with male gender, extra-articular features, and a severe course of RA as indicated by the presence of joint destruction and need for intensive treatment with antirheumatic drugs. The strongest association was found with the presence of increased concentrations of rheumatoid factor.
Voskuyl
A E
AE
Department of Rheumatology, University Hospital, Leiden, Netherlands.
Zwinderman
A H
AH
Westedt
M L
ML
Vandenbroucke
J P
JP
Breedveld
F C
FC
Hazes
J M
JM
D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010396:Penicillamine / Q000009:adverse effects / Q000627:therapeutic use; D012217:Rheumatoid Factor / Q000097:blood; D012737:Sex Factors; D014657:Vasculitis / Q000209:etiology*
D000305:Adrenal Cortex Hormones; D018501:Antirheumatic Agents; D012217:Rheumatoid Factor; D010396:Penicillamine; D001379:Azathioprine