Abstract: Objective To analyze the characteristics of rare clinical manifestation of rheumatoid arthritis(RA) with ANCA-associated vasculitis(AAV). Methods 5 hospitalized patients from Peking Union Medical College Hospital during January 2003 to July 2015 were diagnosed as RA with AAV. The medical records were retrospectively analyzed for clinical manifestations, laboratory examination, imaging findings, and pathological results of renal needle biopsy. Results 5 patients (3 female and 2 male) were diagnosed as microscopic polyangiitis (MPA), and all previously diagnosed with RA. All patients had renal abnormalities (100%), and pulmonary (60%), ENT (20%) and eye (20%) involvement was found. Wight loss was found in 2 patients. Conclusions RA with AVV is a rare clinical manifestation, but these two diseases may have a mutual genetic predisposition. Complication with AAV should be taken into considerations while new-onset renal abnormalities was found in RA patients without hypertension, diabetes, or related medication history.

Key words: ANCA-associated vasculitis, rheumatoid arthritis, clinical features