Rheumatoid vasculitis is a condition with a strong HLA association - 88% have tissue type HLA DR4.
- usually, it occurs in sero-positive patients with long-standing disease
- while small vessel disease with a leucocytoclastic pattern is most frequently seen, there can also be disease of larger vessels when the inflammation may be granulomatous
- immunoglobulin and complement are present in active lesions
- rheumatoid arthritis patients with vasculitis usually have active disease with IgM anti-IgG rheumatoid factor ANA and other autoantibodies usually present in the circulation.
In 85% of cases there is skin involvement with deep cutaneous ulcers and digital and nailfold infarcts. The activity of the disease is associated with high levels of IgG, rheumatoid factor and low levels of complement.
- Davies DJ. Small vessel vasculitis. Cardiovascular Pathology 2005; 14 (6): 335-346.