Clinical background of rheumatoid vascular disease.

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Abstract
Cases of rheumatoid arthritis with and without vascular complications were compared. The patients with vascular lesions were all sero-positive, but showed a significantly longer duration of disease, a higher incidence of subcutaneous nodules, a similar incidence of previous corticosteroid therapy, and a much poorer prognosis when compared with sero-positive patients without clinical vascular disease. The differences in duration of disease and incidence of subcutaneous nodules were even more marked between the patients with vascular lesions and the sero-negative patients, but in addition the latter included significantly more with less than 4 joints affected and fewer previously treated with corticosteroids. Detailed family histories revealed a similar incidence of rheumatoid arthritis among the relatives of sero-positive patients with and without vascular lesions, but significantly fewer cases among the relatives of sero-negative patients. Of the other diseases sought, the only significant finding was a higher incidence of psoriasis among relatives of patients with vascular disease. Rheumatoid vascular disease represents an extension in severity and distribution of microscopic vascular changes seen early in sero-positive rheumatoid disease but it produces clinically recognizable lesions only at a late stage of the disease.