case_images: PMC6830207_01
case_images: Left sural nerve.. Small muscular arteries showing chronic inflammatory cells in the wall and fibrin deposition.
case_images: ZJCH_A_1676507_F0001_OC.jpg
case_images: PMC6830207_01_ZJCH_A_1676507_F0001_OC.jpg
case_images: F0001
case_images: SPEP. A non-contrast MRI of the lumbar spine was unremarkable. She had elevated RF (585 IU/mL) with normal C3 (133.2 mg/dl) and low C4 (8.4 mg/dl). Left Sural nerve biopsy revealed vasculitis (Figure 1), confirming the diagnosis of mononeuritis multiplex due to rheumatoid vasculitis. She was treated with methylprednisone 1 gram daily for 3 days followed by a prednisone taper.