There are times in cases of lupus and RA when the disease takes a different course because a different type of vasculitis has developed or because the blood vessel inflammation increases to become a larger part of the problem. If that happens, you start getting sicker and develop a fever. These are clues to the physician that there has been a change in the course of illness. In those cases, we say "This is lupus complicated by vasculitis" or "this is rheumatoid arthritis complicated by vasculitis." The disease has changed its character and usually needs more vigorous treatment