009. Vasculitis Flashcards
What is meant by a vasculitits?
Inflammatory disorders of blood vessels
Split into large medium and small depeding on the size of blood vessel they affect
Provide some examples of vasculitis’?
Large- giant cell arteritis
Medium- polyarteritis nodosa, Kawasaki disease
Small- Wegner’s granulomatosis, goodpasture’s disease, IgA vasculitis
What are some appropriate first investigations when looking at vascultiis?
ESR/CRP
ANCA
Creatinine
Proteinuria, heamaturia
Angiogrpahy and biopsy for diagnosis
What are the symptoms of giant cell arteritis?
Headache, temporal artery and scalp tenderness
Tongue, jaw claudication
Sudden unilateral blindness
malaise, dypnoea, weight loss
How do you manage giant cell arteritis?
Prednisolone#
PPI
Bisphosphonates
Calcium with colecalciferol
What is polyarteritis nodosa?
Necrotizing vasculitis that causes aneurysms and thrombosis in medium sized arteries
What disease is polyarteritis nodosa associated with?
Hep B
What are the symptoms of polyarteritisi nodosa?
Skin rash and ulcers
Renal abnormalities (renal artery narrowing, gloemerular ischemia)
Cardiac, GI, neuro involvement
How do you treat polyarteritis nodosa
Control blood pressure
Steroids if mild
Steroid sparing agents if more severe
What is microscopic polyangitis?
Necrotizing vasculitis affecting small and medium sized vessels
What are the symptoms for microscopic polyangitis?
Rapidly progressive glomerulonephritis usually features pulmonary heamorrhage
What is the treatment for microscopic polyangitis?
Steroids and DMARD- acute flare
Methotrexate, rituximab, azathiopurine
What is polymyalgia rheumatica?
Not a true vascultitis that causes bilateral aching, tenderness and morning stiffness
What are the symptoms of polymyalgia rheumatica?
Fever
Decreased weight
Anorexia
depression
polyarthritis, tenosynovitis, carpal tunnel syndrome
How do you manage polymatica rheumalgia?
Pred
Methotrexate considered in some cases
Warn of link with giant cell arteritis and to watch for symptoms
