Association of ANCA-associated vasculitis-rheumatoid arthritis overlap syndrome in four patients: Rituximab may be the right choice?
2012; Informa; Volume: 45; Issue: 4 Linguagem: Inglês
10.3109/08916934.2012.677078
ISSN1607-842X
AutoresMária Szilasi, János Mátyus, Ibolya File, Gabriella Szűcs, Éva Rákóczi, György Pfliegler, Zoltán Szabó, Edit Végh, Zoltán Szekanecz,
Tópico(s)Urticaria and Related Conditions
ResumoThere have been few reports on the association of rheumatoid arthritis (RA) with anti-neutrophil cytoplasmic antigen (ANCA)-associated systemic vasculitides.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.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.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.
Referência(s)