ABSTRACT

Vasculitis, is one of the complications of rheumatoid arthritis (RA) which is rarely seen after the common use of DMARDs and biologic drugs. Leflunomide is a DMARD and neuropathy is one of its rare adverse effects. A 67-year-old male patient with RA was admitted with neuropathy after 5 years of leflunomide treatment. Although the first complaints were thought to be associated with leflunomide, there was no improvement three months after the withdrawal of the drug. Sural nerve biopsy was compatible with rheumatoid vasculitis. After immunosuppresive therapy his complaints improved. Vasculitis and neuropathy are the complications of RA. Leflunomide can also cause neuropathy. Differentiating leflunomide related neuropathy from rheumatoid vasculitis can be difficult in nevre biopsies since features of vasculitis can also be seen in neuropathy due to leflunomide toxicity.