Case Report: Aortitis associated with rheumatoid arthritis: A challenging rheumatoid vasculitis presentation

Abstract

Rheumatoid vasculitis (RV) is a rare but serious extra-articular manifestation of rheumatoid arthritis (RA). Its varied clinical presentation makes it hard to diagnose and treat. Hereby we describe a case of an aortitis revealing RV, which is a rare presentation of a rare complication of RA. A 56-year-old man with rheumatoid arthritis treated with methotrexate presented with fever, chest pain and arthritis. Blood tests revealed inflammatory syndrome associated with cholestasis. The diagnosis of pericarditis associated with aortitis was retained. Cholestasis was mostly due to methotrexate. The patient was treated with cyclophosphamide pulses and high doses of prednisolone. The patient was in complete remission of articular and extra-articular manifestations after two months of treatment.