Prednisone Plus Azathioprine Treatment in Patients With Rheumatoid Arthritis Complicated by Vasculitis

Heurkens, A. H. M.

doi:10.1001/archinte.1991.00400110099020

Cited by 48 publications

(16 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, patients with RV with non-severe superficial skin lesions-for example, purpura/petechiae or superficial skin ulcers, do not have a poor prognosis and a change of disease modifying antirheumatic drug (DMARD) treatment may be sufficient for these patients, instead of treating them with aggressive immunosuppressive drugs. 31 Three of our patients with RV had a rash as the only clinical manifestation in combination with vasculitis in the skin biopsy and, interestingly, also in a muscle biopsy. This observation suggests that some patients with skin rash apparently may have systemic vasculitis.…”

Section: Discussionmentioning

confidence: 61%

Diagnostic strategy for the assessment of rheumatoid vasculitis

Voskuyl

Hazes²,

Zwinderman³

et al. 2003

Annals of the Rheumatic Diseases

View full text Add to dashboard Cite

Objective: To determine the clinical features associated with histologically proven rheumatoid vasculitis (HRV) and the additional diagnostic value of serological markers in an inception cohort of 81 patients with rheumatoid arthritis (RA) suspected of RV. Methods: The presence and number of recently developed extra-articular manifestations (EAMs) and a weighted EAM score, as well as the levels of serological markers, were compared between 31 patients with RA with histologically proven vasculitis and 50 patients with RA in whom vasculitis could not be documented histologically. The following markers were evaluated: circulating immune complexes, complement components C3 and C4, class-specific rheumatoid factors (IgM RF, IgG RF, IgA RF), antineutrophil cytoplasmic antibodies, antinuclear antibodies, antiendothelial antibodies, circulating intercellular adhesion molecule-1 and -3, circulating vascular cell adhesion molecule and E-selectin, cellular fibronectin, von Willebrand factor antigen, and C reactive protein. The diagnostic value of these markers, in addition to the clinical features, was evaluated with logistic regression analysis. Results: Peripheral neuropathy or purpura/petechiae, or both, were the most important clinical features to discriminate patients with RA with and without histologically proven RV. The presence of a high number of EAMs and a higher weighted EAM score in patients with RA suspected of vasculitis were also associated with an increased probability of histologically proven RV. After adjustment for EAMs, only the combination of an increased serum IgA RF level and a decreased serum C3 level appeared to make an additional contribution to the diagnosis histologically proven RV. Evidence of systemic vasculitis was found in a muscle biopsy of the rectus femoris in 9/14 (64%) patients with vasculitis with neuropathy and in 3/11 (27%) patients with purpura/petechiae and vasculitis of the skin. Conclusions: In the diagnostic process of RV the presence of peripheral neuropathy and/or purpura/ petechiae or a high weighted EAM score will increase the probability of histologically proven RV. Of the circulating factors previously suggested to be markers for RV only IgA RF and C3 further increase the probability of histologically proven RV and may be useful to guide diagnostic decisions.

show abstract

Section: Discussionmentioning

confidence: 61%

Diagnostic strategy for the assessment of rheumatoid vasculitis

Voskuyl

Hazes²,

Zwinderman³

et al. 2003

Annals of the Rheumatic Diseases

View full text Add to dashboard Cite

show abstract

“…152 Other uses Azathioprine has been reported to be successful not only in immunobullous, photodermatotic, and eczematous diseases but also in a number of other severe or recalcitrant conditions. As shown in Table V, azathioprine has been used to treat Behçet syndrome, 153,154 pityriasis rubra pilaris, 155 erythema multiforme, [156][157][158] lichen planus, [159][160][161] vasculitis, [162][163][164][165][166][167] cutaneous lupus, 163,[168][169][170] Reiter syndrome, 171 graftversus-host disease, 172,173 prurigo nodularis, 174 Sulzberger and Garbe, 175 and acne fulminans. 176 The evidence for Behçet syndrome is encouraging, and early treatment with azathioprine has been shown to favorably affect the long-term prognosis of the disease.…”

Section: Photodermatosesmentioning

confidence: 99%

Azathioprine in dermatology: The past, the present, and the future

Patel

Swerlick

McCall

2006

Journal of the American Academy of Dermatology

160

136

View full text Add to dashboard Cite

“…Beissert et al, 7 Guillaume et al, 19 Burton and Greaves, 10 Burton et al, 11 Ahmed et al, 5 Heurkens et al, 20 Callen et al, 13 pared with 67% in the betamethasone group (PϾ.05). It was unclear in the RCT who measured the severity of parthenium dermatitis and whether this was performed in a masked fashion.…”

Section: Parthenium Dermatitis (An Airborne Plant Allergen Contact Dementioning

confidence: 98%

“…12,13,20 Regarding the RCT, prednisolone with azathioprine (2.0 mg/kg/d) was compared with different conventional antirheumatic treatments (including nonsteroidal anti-inflammatory drugs, hydroxychloroquine, aurothioglucose, penicillamine, and sulfasala- zine) in 19 patients with cutaneous vasculitis characterized by palpable purpura, ulcers, nail fold infarcts, peripheral gangrene, and histologic features of small vessel infiltration. 20 In the azathioprine group, a significant reduction of skin vasculitis occurred after 18 months; 7 patients (88%) achieved complete remission. This finding was not statistically significant compared with the conventional treatment group.…”

Section: Cutaneous Vasculitismentioning

confidence: 99%

Off-label Use of Azathioprine in Dermatology

Schram¹

2011

Arch Dermatol

View full text Add to dashboard Cite

Prednisone Plus Azathioprine Treatment in Patients With Rheumatoid Arthritis Complicated by Vasculitis

Cited by 48 publications

References 35 publications

Diagnostic strategy for the assessment of rheumatoid vasculitis

Diagnostic strategy for the assessment of rheumatoid vasculitis

Azathioprine in dermatology: The past, the present, and the future

Off-label Use of Azathioprine in Dermatology

Contact Info

Product

Resources

About