Fana M, Chao S, and Katramados AM. Rituximab for prevention of strokes in cerebral rheumatoid vasculitis. Clin Neurol Neurosurg 2022; 215:107199.
Clinical neurology and neurosurgery
Rheumatoid arthritis (RA) is an autoimmune disorder which manifests as inflammation of the synovial joints alongside extra-articular involvement. Uncommonly, patients may develop vasculitis of small and medium-sized blood vessels, formally diagnosed as systemic rheumatoid vasculitis (SRV). In particularly rare cases, patients may develop a subtype of SRV known as cerebral rheumatoid vasculitis (CRV) which manifests in patients as stroke. To date, no formal recommendations or guidelines have been established for treatment and prevention of CRV-induced stroke besides experiential therapy with various immunomodulators. Here, we describe the utility of Rituximab in addition to steroids for prevention of stroke in our patient with evidence of multiple CRV-induced strokes with excellent recovery of post-stroke symptoms and remission of new onset cerebral vasculitis processes.
Medical Subject Headings
Arthritis, Rheumatoid; Humans; Immunologic Factors; Rheumatoid Vasculitis; Rituximab; Stroke; Vasculitis, Central Nervous System