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

Mária Szilasi, János Mátyus, Ibolya File, Gabriella Szücs, Éva Rákóczi, György Pfliegler, Zoltán Szabó, Edit Végh, Zoltán Szekanecz

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6 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)304-309
Number of pages6
JournalAutoimmunity
Volume45
Issue number4
DOIs
Publication statusPublished - Jun 1 2012

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Keywords

  • ANCA-associated vasculitis
  • Churg-Strauss syndrome
  • Rheumatoid arthritis
  • Wegener's granulomatosis
  • microscopic polyangiitis
  • rituximab

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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