Association of ANCA-associated vasculitis-rheumatoid arthritis overlap syndrome in four patients: rituximab may be the right choice?

Abstract:

OBJECTIVES:There have been few reports on the association of rheumatoid arthritis (RA) with anti-neutrophil cytoplasmic antigen (ANCA)-associated systemic vasculitides. METHODS:Here we present four cases of RA overlapping with Wegener's granulomatosis (WG), microscopic polyangiitis (MPA) and Churg-Strauss syndrome (CSS). All these cases had both the diagnosis of RA and that of ANCA-associated vasculitis. RESULTS:After we tried corticosteroids, multiple immunosuppressive drugs, sometimes plasmapheresis, rituximab was introduced to 3 out of 4 cases. Rituximab therapy was found to be effective in these three overlap cases. In the fourth case, rituximab was and will be considered; however, the patient has not given consent. CONCLUSION:To our knowledge, this is the first report on RA+CSS association. Common pathogenic background, such as genetic predisposition and ANCA may account for the development of RA+vasculitis overlaps. In DMARD-refractory cases, such as the ones presented here, biologics, especially rituximab may be highly effective.

journal_name

Autoimmunity

journal_title

Autoimmunity

authors

Szilasi M,Mátyus J,File I,Szücs G,Rákóczi E,Pfliegler G,Szabó Z,Végh E,Szekanecz Z

doi

10.3109/08916934.2012.677078

subject

Has Abstract

pub_date

2012-06-01 00:00:00

pages

304-9

issue

4

eissn

0891-6934

issn

1607-842X

journal_volume

45

pub_type

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