THE RELATIONSHIP OF THERAPY WITH CORTISONE TO THE INCIDENCE OF VASCULAR LESIONS IN RHEUMATOID ARTHRITIS

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Abstract
All instances of rheumatoid arthritis examined at necropsy at the Mayo Clinic through 1954 were reviewed, with special emphasis on the incidence and character of the vascular lesions and their relationship to the administration of cortisone. There were 52 patients in the study. Fourteen of these had received cortisone and 38 had not. Four (29%) of the group of 14 treated with cortisone had generalized lesions of polyarteritis nodosa, whereas none of the 38 patients who did not receive cortisone had such lesions. These findings suggest that, in certain susceptible patients with rheumatoid arthritis, the administration of cortisone may precipitate the development of diffuse necrotizing arteritis. The explanation as to why this may occur in some patients with rheumatoid arthritis treated with cortisone and apparently not in patients with other diseases (with the possible exception of disseminated lupus erythematosus) is not clear at the present time. We found no vascular lesions specific for rheumatoid arthritis in this study.