Successful treatment of severe rheumatoid vasculitis by infliximab.

Rheumatoid vasculitis (RV) is a severe complication of rheumatoid arthritis (RA), which like a primary necrotising vasculitis can affect any organ but characteristically presents with painful cutaneous ulcers and systemic inflammation. 2 Usually patients with refractory RA are affected who, therefore, had already undergone extensive immunosuppressive treatment. The prognosis is poor and most patients die from infectious complications, cardiac failure, or cerebral insult. Cyclophosphamide (CYC) is the preferred treatment but is often not well tolerated and does not contain the synovitis. We report the cases of three patients with RV who could not sufficiently be treated by CYC and steroids but responded very well to infliximab infusion therapy.