Open Access Rheumatology: Research and Reviews (Jul 2022)

Rheumatoid Vasculitis, an Uncommon Complication of Non-Deforming Rheumatoid Arthritis: A Case Report

  • Taha ZI,
  • Abdalla YA,
  • Hamza SB,
  • Eltagalawi MF,
  • Abubakr ME,
  • William J,
  • Abdalgadir SA

Journal volume & issue
Vol. Volume 14
pp. 141 – 146

Abstract

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Ziryab Imad Taha,1– 4 Yassin Abdelrahim Abdalla,4,5 Salih Boushra Hamza,4,5 Mohammed Faisal Eltagalawi,4,6,7 Mohammed Elmuntaga Abubakr,1,4 Jimmy William,4,8 Sami Ahmed Abdalgadir4,9 1Internal Medicine Department, Haj El-Safi Teaching Hospital, Khartoum-North, Sudan; 2Rheumatology Department, Sudanese Medical Specialization Board, Khartoum, Sudan; 3Faculty of Medicine, University of Bahri, Khartoum, Sudan; 4Rheumatology Department, Ziryab Research Group, Khartoum, Sudan; 5Internal Medicine Department, Omdurman Islamic University, Khartoum, Sudan; 6Anatomy Department, Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan; 7Integration Department, Omdurman Islamic University, Omdurman, Sudan; 8General Internal Medicine Department, Sligo University Hospital, Sligo, Ireland; 9Radiology Department, Omdurman Military Hospital, Omdurman, SudanCorrespondence: Jimmy William, Sligo University Hospital, The Mall, Rathquarter, Sligo, F91 H684, Ireland, Tel +353851173213, Email [email protected]: We present an 18-year-old female from South Sudan presented with right fingertips ulceration and black discolouration associated with bilateral wrist/metacarpophalangeal joints pain for five months. The ulceration began at the tip of the right middle finger and gradually progressed to involve the rest of the hand and was associated with agonizing pain. A Doppler study of the right upper limb revealed thrombosis of the antecubital portion of the basilar, ulnar, and part of the distal radial arteries. Blood investigations showed high anti-CCP, doubtful rheumatoid factor titre and ANA titre of 1:320 with coarse and nucleated cells; however, all ANA parameters were negative. A definitive diagnosis of rheumatoid arthritis complicated by rheumatoid vasculitis was made. Unfortunately, the middle finger could not be preserved and ended up amputated, and the patient was commenced on steroids, DMARDs and warfarin. The patient responded very well to the management plan with pain alleviation, ulcers healing and clot resolution.Keywords: rheumatoid arthritis, vasculitis, thrombosis, ulcers, DMARDs

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