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What is Rheumatoid Vasculitis?

Rheumatoid vasculitis is a rare complication of arthritis that causes inflammation and constriction of blood vessels. The condition tends to affect veins and arteries near the skin, though vessels in the eyes, gastrointestinal tract, and near internal organs may also be involved. Most cases of rheumatoid vasculitis and underlying joint arthritis can be treated with prescription anti-inflammatory drugs. Surgery may be necessary if serious nerve, organ, or bone complications occur.

Rheumatoid arthritis is an autoimmune disorder in which the immune system mistakenly inhibits healthy joint tissue, causing inflammation, pain, and swelling. A very small percentage of rheumatoid arthritis patients develop signs of vasculitis, usually at least ten years after the onset of joint problems. The condition is most likely to cause problems in arteries and veins near the joints that are troubled by arthritis, but it can potentially become widespread. Inflamed blood vessels swell, thicken, and narrow, leading to a number of obvious and often painful physical symptoms.

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A person who has rheumatoid vasculitis may notice tender, darkened areas of skin around the nail beds of the fingers or toes. Open lesions called cutaneous ulcers can appear on the skin over time as localized inflammation worsens. Blood vessels in one or both eyes can also be affected, leading to reddening and vision changes. A person can experience numbness or tingling sensations in an extremity if the blood supply to major nerves is impeded. Less commonly, major arteries in the chest, abdomen and legs can become constricted and cause potentially life-threatening blood pressure and circulation issues.

Almost all people who experience rheumatoid vasculitis are already aware that they have arthritis. Doctors can usually diagnose vasculitis by carefully examining the eyes and skin. Blood tests can help specialists rule out other conditions, such as infections, that might be causing symptoms. A tissue biopsy from an affected blood vessel is performed to confirm the nature and severity of inflammation.

After making a diagnosis, a doctor can determine the best treatment option. In addition to taking medications to control joint inflammation, a patient may need to take specialized drugs designed to keep blood vessels dilated and promote healthy blood pressure levels. Rheumatoid vasculitis of the eyes often requires surgery to prevent permanent vision loss. A patient may also need to use topical or oral antibiotics if he or she has open lesions to lessen the chances of infection. Rheumatoid arthritis is usually a lifelong condition, but symptoms of vasculitis do not always persist over the course of a lifetime.

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