title: Rheumatoid vasculitis of crural muscles confirmed by muscle biopsy in the absence of inflammatory myopathy: histologic and MRI study.
abstract: A 60-year-old man who had been diagnosed as rheumatoid arthritis admitted to our hospital by dysesthesia on his legs with edema. Nerve conduction velocity test led to diagnosis of mononeuritis multiplex. Magnetic resonance imaging (MRI) of lower legs showed high intensity in slow tau inversion recovery. Typical vasculitis with neutrophil-dominant cell infiltration was observed by muscle biopsy without inflammatory myopathy or fascitis. Diagnosis was made by rheumatoid vasculitis found in crural muscles. Intravenous cyclophosphamide with oral tacrolimus effectively improved dysesthesia with reduction of inflammatory response.
authors.affiliation: Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan. nhideki@nagasaki-u.ac.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Akitomo
authors.initials: A
authors.lastname: Okada
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamasaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ida
authors.forename: Tomoko
authors.initials: T
authors.lastname: Masuda
authors.forename: Taku
authors.initials: T
authors.lastname: Fukuda
authors.forename: Katsuya
authors.initials: K
authors.lastname: Satoh
authors.forename: Toshiro
authors.initials: T
authors.lastname: Yoshimura
authors.forename: Munetoshi
authors.initials: M
authors.lastname: Nakashima
authors.forename: Tomayoshi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Katsumi
authors.initials: K
authors.lastname: Eguchi
mesh_terms: D000284:Administration, Oral; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D001706:Biopsy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology* / Q000503:physiopathology; D009135:Muscular Diseases / Q000150:complications / Q000473:pathology*; D009431:Neural Conduction; D009504:Neutrophils; D010292:Paresthesia / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D016559:Tacrolimus / Q000627:therapeutic use; D016896:Treatment Outcome; D014657:Vasculitis / Q000150:complications / Q000188:drug therapy / Q000473:pathology*
chemical_list: D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D016559:Tacrolimus