Improved rheumatoid digital vasculitis in a patient treated with TNFalpha agent blocking (infliximab).
Rheumatoid vasculitis (RV) is an uncommon but potentially catastrophic complication of rheumatoid arthritis (RA). There are few current extensive studies and no consensus regarding the clinical, laboratory, histologic features and management or prognosis of RV. We report a case of RV in a 74-year old woman with a long (14 years) history of RA, who developed vasculitis of distal arteries with gangrene of digits of upper and lower extremities. After the failure of various immunosuppressive drugs (cyclophosphamide, methotrexate), the patient was treated with anti-TNFalpha infliximab. Digital gangrene healed within four months from the start of anti-TNFalpha treatment.
Benucci
Maurizio
M
Rheumatology Unit, Nuovo Ospedale S. Giovanni di Dio, ASL 10 Florence via di Torregalli 3, Florence, Italy. maubenucci@tiscali.it
Li Gobbi
Francesca
F
Saviola
Gianantonio
G
Manfredi
Mariangela
M
D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005385:Fingers / Q000098:blood supply / Q000473:pathology; D006801:Humans; D000069285:Infliximab; D009336:Necrosis / Q000188:drug therapy / Q000209:etiology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014657:Vasculitis / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology
D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab