THE PREVALENCE OF RHEUMATOID VASCULITIS AND ITS RISK FACTORS IN RHEUMATOID PATIENTS OF RHEUMATOLOGY CLINIC OF SHARIATI HOSPITAL FROM 2009-2019

Rheumatoid disease is a systemic inflammatory disease with an unknown cause that in addition to joint involvement can have extra-articular manifestations with involvement of any organ. The presence of extra-articular manifestations is associated with poor prognosis and increased mortality. Risk factors for rheumatoid vasculitis include the duration of disease, the presence of rheumatoid nodules, smoking, RF with high titers, and genetic predisposition. Given that no study in Iran has analyzed the prevalence of rheumatoid vasculitis and its risk factors and the fact that the incidence of the disease can be controlled by understanding the changeable risk factors, this study was conducted.

460 patients with rheumatoid arthritis were studied and individuals with rheumatoid vasculitis were identified. Both groups were examined and analyzed in terms of sex, smoking, rheumatoid nodules, RF antibodies, and Anti CCP. Their relationship was assessed by Fisher's exact test or Ka-score. In addition, vasculitis group was evaluated for disease activity based on DAS-28 and acute phase reactants.

Out of 460 patients, 6 patients (1.3%) had rheumatoid vasculitis (3 males and 3 females). The mean duration of the disease at the time of vasculitis was 12.83 years. Of these 6 patients, 3 had mononeuritis multiplex (50%), 2 had scleritis (33%), and one had cutaneous vasculitis (16.6%). None of the patients had subcutaneous nodules. One patient was smoker (16.7%). The mean ESR in vasculitis subjects was 63.16 mm / h and the mean CRP was 37.0 mg / L. Anti CCP antibody was positive in 4 patients (80%) and negative in one patient. RF antibody was positive in 5 patients (100%) and one was not registered. The mean disease activity based on DAS-28 in 4 patients out of 6 patients was 3.73.

In this study, the prevalence of rheumatoid vasculitis was estimated to be 1.3% and there was no statistically significant relationship between rheumatoid vasculitis and the presence of rheumatoid nodules, smoking, RF autoantibodies and Anti CCP. This result could be due to the low volume of the sample in the vasculitis group.