Abstract
Rheumatoid arthritis mainly consists of arthritis, and the fatal prognosis is decided by extra-articular manifestations. Vascular lesion is one of the most serious extraarticular manifestations. One hundred thirty two patients with classical or definite rheumatoid arthritis were sellected as subjects, and were divided into three groups according to the presence of symptoms probably due to vasculitis. In addition, the clinical significance and the pathogenesis of vasculitis were studied. Vasculitis were seen in about 30% of all the patients. These were subcutaneous nodules (22.7%), episcleritis (6.1%), polyneuritis (3.8%), pneumonitis (3.0%), pleuritis (2.3%), pericarditis (2.1%) and skin ulceration (1 patient) in order. More than two symptoms of vasculitis were seen in 10%, and one in 21%. The patient with more than two symptoms of vasculitis occasionally had marked joint erosion, and showed a high mortality. All these patients had rheumatoid factor of a high titer. Antinuclear factor was positive in 50%. Many had been treated with high doses of corticosteroid. It was difficult to demonstrate the relationship between rheumatoid arthritis accompanied by vasculitis and malignant rheumatoid arthritis. Most patients with rheumatoid arthritis who had one symptom of vasculitis consisted of those with subcutaneous nodules showed a low mortality. The patients who had more than two symptoms of vasculitis showed a high mortality, and were considered to occasionally include the patients with malignant rheumatoid arthritis.
