Published in:
01-08-2010 | Case Report
Rheumatoid vasculitis of crural muscles confirmed by muscle biopsy in the absence of inflammatory myopathy: histologic and MRI study
Authors:
Hideki Nakamura, Akitomo Okada, Atsushi Kawakami, Satoshi Yamasaki, Hiroaki Ida, Tomoko Masuda, Taku Fukuda, Katsuya Satoh, Toshiro Yoshimura, Munetoshi Nakashima, Tomayoshi Hayashi, Katsumi Eguchi
Published in:
Rheumatology International
|
Issue 10/2010
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Abstract
A 60-year-old man who had been diagnosed as rheumatoid arthritis admitted to our hospital by dysesthesia on his legs with edema. Nerve conduction velocity test led to diagnosis of mononeuritis multiplex. Magnetic resonance imaging (MRI) of lower legs showed high intensity in slow tau inversion recovery. Typical vasculitis with neutrophil-dominant cell infiltration was observed by muscle biopsy without inflammatory myopathy or fascitis. Diagnosis was made by rheumatoid vasculitis found in crural muscles. Intravenous cyclophosphamide with oral tacrolimus effectively improved dysesthesia with reduction of inflammatory response.