Skip to main content Skip to main navigation menu Skip to site footer

Rheumatoid Vasculitis and Blepharitis Caused By Rheumatoid Arthritis In 6 Years Old Boy: A Case Report

Abstract

Link of Video Abstract: https://youtu.be/4Guk_6foSxw

 

Introduction: Rheumatoid Vasculitis (RV) is a rare complication affecting approximately 1% of patients with severe rheumatoid arthritis. This condition is an extra-articular manifestation of rheumatoid arthritis that affects the small and medium arteries in the body. Vasculitis is an inflammatory necrotizing vascular wall disease that can occur in autoimmune disease. This inflammation leads to damage in blood vessels due to stenosis or occlusion and thrombosis, resulting in pain, necrosis, and aneurysm. Inflammation can be primary or secondary. Skin, fingers, peripheral nerves, eyes and the heart are the most commonly affected areas.

Case description: We report a case of a 6-year-old boy who presented RV and blepharitis. The patient subsequently experienced nail fold infarcts and gangrene of his left finger. He was found to fulfill Jones Criteria, and treatment with aspirin and corticosteroids significantly improved his symptoms. This rare case describes the early onset of rheumatoid vasculitis in a patient with rheumatoid arthritis. Rheumatoid vasculitis is a systemic disease that develops from rheumatoid arthritis with rheumatoid autoantibodies and extra-articular manifestations characterized by tissue damage or ischemia involving the skin and peripheral nerves. The incidence of rheumatoid vasculitis in children is less than 1%, with  12 to  53 cases per 100,000 children under 17 years old.

Conclusion: Rheumatoid vasculitis is a rare complication of rheumatoid. This condition occurs in patients who have rheumatoid arthritis for a long period. The patient will prevent further complications with early diagnostic and proper treatment.

References

  1. Bartels C.M, Bridges A.J. Decline in rheumatoid vasculitis prevalence among US veterans Arthritis Rheum. 2010 Dec;12(6):414-419.
  2. Gardner M, Dolezalova P. Vasculitis in children: incidence and classification. 2002;360(9341):1197.
  3. Watkins DA, Johnson CO, Colquhoun SM, Karthikeyan G, Beaton A, Bukhman G, Forouzanfar MH, Longenecker CT, Mayosi BM, Mensah GA, Nascimento BR, Ribeiro ALP, Sable CA, Steer AC, Naghavi M, Mokdad AH, Murray CJL, Vos T, Carapetis JR, Roth GA. Global, Regional, and National Burden of Rheumatic Heart Disease, 1990-2015. N. Engl. J. Med. 2017 Aug 24;377(8):713-722.
  4. Narenza CD, Habibie YA. A challenging triple valve surgery for long-standing pulmonary hypertension in rheumatic heart disease: a case report. Bali Medical Journal. 2023 Jan 25;12(1):404-9.
  5. Gerber MA. Group A Streptococcus. In: Behrman RE, Kliegman RM, Jenson HB, Stanton BF. In : Nelson textbook of pediatrics; 18th ed. Philadelphia: WB Saunders Co. 2007;1140-45.
  6. Madiyono B, Rahayuningsih SE, Sukardi R. Demam rheumatik akut dan penyakit jantung rheumatik. Dalam : Penanganan penyakit jantung pada bayi dan anak .Jakarta: Departemen Ilmu Kesehatan Anak FKUI RSCM FKUI. 2009:95-14.
  7. Anja S and Chrisrtian M. Childhood vasculitis, Frontiers in pediatric. 2018;6:42.
  8. Sutawan IB, Putera AM, Hikmah Z, Endaryanto A. Urticarial vasculitis associated with post-streptococcal disease in children: a case report. Bali Medical Journal. 2023 Feb 1;12(1):501-5.
  9. Abdulqader Y, Al-Ani M, Parperis K. Rheumatoid vasculitis: early presentation of rheumatoid arthritis. Case Reports. 2016 Nov 8;2016:bcr2016217557.
  10. Scott DG, Bacon PA. Intravenous cyclophosphamide plus methylprednisolone in treatment of systemic rheumatoid vasculitis. Am J Med. 1984 Mar;76(3):377-84. doi: 10.1016/0002-9343(84)90654-5. PMID: 6142648.
  11. Rilantomo, LI. Penyakit Kardiovaskular (PKV), Jakarta: fakultas kedokteran Universitas Indonesia. 2013:331-335
  12. Park MK. Acute rheumatic fever. In: Pediatric cardiology for practitioners. 6th ed. Philadelphia: saunders. 2014:343-464
  13. ikatan Dokter Anak Indonesia. Pedoman Pelayanan Medis, Ed.2.Jakarta :Publishing agency Ikatan Dokter Anak Indonesia. 2011:41-42
  14. Heurkens AH, Westedt ML, Breedveld FC. Prednisone plus azathioprine treatment in patients with rheumatoid arthritis complicated by vasculitis. Arch Intern Med. 1991;151(11):2249

How to Cite

Lawang, S. A., Hakka , H. M. ., Nurdin , M. M. ., & Maulani , D. . (2023). Rheumatoid Vasculitis and Blepharitis Caused By Rheumatoid Arthritis In 6 Years Old Boy: A Case Report. Bali Medical Journal, 12(3), 2963–2967. https://doi.org/10.15562/bmj.v12i3.4789

HTML
0

Total
0

Share

Search Panel

Sitti Aizah Lawang
Google Scholar
Pubmed
BMJ Journal


Hasriani Muhammad Hakka
Google Scholar
Pubmed
BMJ Journal


Mulawardi Muhammad Nurdin
Google Scholar
Pubmed
BMJ Journal


Destya Maulani
Google Scholar
Pubmed
BMJ Journal