What is rheumatoid vasculitis?
Rheumatoid vasculitis is a rare complication of rheumatoid arthritis (RA) that causes inflammation in the blood vessels. This inflammation can reduce blood flow and damage the tissues those vessels support. It can affect many parts of the body but most often involves the skin and nerves. This condition usually develops in people who have had severe, often untreated, RA for many years. If not treated, it can lead to serious issues like skin ulcers, nerve damage, or even organ failure.
Rheumatologists manage rheumatoid vasculitis and RA. Depending on your symptoms and which organs are involved, your care team may also include other experts like neurologists, dermatologists, or eye specialists. At Penn Medicine, we take a team-based approach to your care, using advanced diagnostic tools and the latest treatments to help you manage your condition and protect your health.
Rheumatoid vasculitis symptoms
Rheumatoid vasculitis can cause a range of symptoms, depending on which parts of the body are affected. Some symptoms are mild, while others can be more serious and need urgent care. One of the earliest signs is a rheumatoid vasculitis rash, which may appear as red spots, purplish bruises, or skin ulcers, especially near the fingertips.
Other symptoms can include:
- Pain in the hands, feet, fingers, or toes
- Numbness, tingling, or loss of feeling, often in the hands and feet
- Muscle weakness
- Fatigue or fever
- Weight loss or loss of appetite
- Chest pain or irregular heartbeat
- Stomach pain
- Eye pain, redness, or blurry vision
What causes rheumatoid vasculitis?
Rheumatoid vasculitis is an autoimmune disease, which means the immune system attacks the body by mistake. In this case, it targets blood vessels. Experts don’t know exactly why this happens, but it’s likely caused by a mix of factors, including problems with the immune system and certain genes. Researchers are still studying what triggers it and why only some people with rheumatoid arthritis develop it.
Rheumatoid vasculitis diagnosis
Rheumatologists use several tests to look for signs of rheumatoid vasculitis and rule out other causes. Blood tests can show inflammation, and blood cultures help check for infection. Your provider may take a small tissue sample (biopsy) to look for signs of blood vessel inflammation. They may also order imaging and nerve tests to check for damage in affected areas.
Treatments for rheumatoid vasculitis
Treatment of rheumatoid vasculitis is based on how severe your vasculitis is and what areas of your body are affected. The goal is to calm your immune system, protect your blood vessels, and help you feel better.
If you have mild symptoms, like skin sores or numbness from nerve problems, your provider may prescribe a corticosteroid like prednisone to reduce swelling and protect your body. If your organs are involved, you might need stronger treatment. This could include high-dose steroids and medications like immunosuppressant drugs, which help slow down an overactive immune system. In some cases, newer medicines called biologics (like anti-TNF drugs) may also be used. These target the immune system more precisely than older drugs.
A long-term partner for vasculitis and RA care
Rheumatoid vasculitis and RA can be complex diseases and affect many parts of the body. At Penn Medicine, our rheumatologists have experience managing these conditions and work closely with other specialists when needed. Throughout your treatment, we take the time to understand your symptoms and create a care plan that’s right for you.
If your condition changes over time, we’ll adjust your treatment and continue monitoring you to help prevent flare-ups. You may also have the chance to take part in a clinical trial, which could give you access to a new therapy before it’s widely available. Through ongoing care and support, we’re here to help you manage your condition for the long term.