Rheumatoid Arthritis Presenting with Raynaud’s Phenomenon in an Elderly: End of Road?

Rheumatoid Arthritis (RA) is an autoimmune and chronic inflammatory disorder where the immune system of the body attacks the healthy cells and causes inflammation. Raynaud’s Phenomenon (RP) is a disorder of small blood vessels supplying the distal parts of the limbs where decrease in blood supply leads to infarction of that area. It occurs secondary to other disorders as in this case with RA. The report is about an 80-year-old female patient who presented with chief complaints of bluish discolouration over distal parts of hands and feet as well as pain in joints of all limbs. She had gangrene developing over the tips of fingers and toes, ulcer over the lower end of right foot, cold extremities, swelling over elbow and knee joints, oedematous hands and feet, and loss of pin prick needle sensations. With all the clinical presentations and investigation findings, the patient was diagnosed with RA presenting with RP. The patient was first started with the treatment for RA and then was managed symptomatically for vasculitis. Due to the old age factor and the advanced stage of the disease, the patient developed septicaemia and died due to cardiac arrest.