BL- VASCULITIS Flashcards
Rheumatoid arthritis (RA) begins with inflammation in which structure/tissue?
Synovium
Clinical presentations of this type of vasculitis include temporal headache, jaw claudication, scalp tenderness, and vision loss
Giant cell arteritis
Typical histology of small vessel vasculitis:
Leukocytoclastic vasculitis
Cytoplasmic –ANCA (c-ANCA) is common to Wegener’s granulomatosis as perinuclear-ANCA (p-ANCA) is common to:
microscopic polyangiitis (MPA)
examples of immune complex (IC)-induced vasculitis
Hepatitis B-associated vasculitis
Cryoglobulinemic vasculitis
Henoch-Schönlein purpura
Hypersensitivity vasculitis (cutaneous leukocytoclastic angiitis)
suspected immunopathogenic mechanisms that mediate vasculitis
Infection of endothelial cells
Immune complexes (IC)
T cell dependent mediated endothelial cell injury
Autoantibodies such as ANCAs and antiendothelial antibodies
Immune complexes (IC)
Vasculitides are a rare group of disorders defined by the size of the vessel involved, the pathologic change in the vessel wall, and the:
clinical presentation
In primary vasculitis, the inciting agent is unknown. The vasculitic response may be due to IC deposition, autoantibodies (anti-endothelial, ANCAs), antigen-driven inflammation, and/or infection of: ______
endothelial cells
heterogeneous group of clinical disorders characterized by inflammation of blood vessels
vasculitides
Vasculitides can be primary or ____ to infectious disorders, drug hypersensitivity, connective tissue diseases, cryoglobulins, and malignancies.
secondary
Large-vessel vasculitis
Giant cell arteritis
Takayasu’s arteritis
Medium-vessel vasculitis
Polyarteritis nodosa
Kawasaki’s disease
Small-vessel vasculitis
(ANCA) positive vasculitides:
Granulomatosis with polyangiitis (Wegener’s)
Eosinophilic granulomatosis with polyangiitis
Microscopic polyangiitis (MPA
Small-vessel vasculitis
(ANCA) negative vasculitides:
Essential cryoglobulinemic vasculitis
Cutaneous leukocytoclastic angiitis
Henoch-Schönlein Purpura (HSP):
vasculitis Labs
anemia of inflammatory disease thrombocytosis low albumin elevated sed rate/crp polyclonal gammopathy
aortic arch and its branches, can involve any part of the aorta; claudication of upper > lower extremities, CNS events; granulomatous panarteritis
Takayasu’s arteritis
temporal arteries
vessels originating from the aortic arch
headache, jaw claudication, scalp tenderness, visual loss;
Giant cell arteritis
small/medium arteries; may affect any organ, but skin, joints, peripheral nerves, gut, and kidney are most commonly involved;
necrotizing arteritis
involvement at the vessel bifurcation
***Polyarteritis nodosa
Wegener’s Granulomatosis
systemic disorder that involves both granulomatosis and polyangiitis. It is a form of vasculitis (inflammation of blood vessels) that affects small- and medium-size vessels in many organs.
Cytoplasmic –ANCA (c-ANCA) is common to Wegener’s granulomatosis as perinuclear-ANCA (p-ANCA) is common to ______ (MPA)*
microscopic polyangiitis
**C-ANCA often binds to
proteinase 3 (PR3) found in the primary granules of neutrophils
**P-ANCA often binds to
myeloperoxidase (MPO) found in primary granules of neutrophils
plasmapheresis______ beneficial in ANCA-positive vasculitides
IS
AFTER treatment of vasculitis high risk of
Atherosclerosis
Hepatitis B virus infection is associated with ______
Polyarteritis nodosa**
Complement decreases in disorders with circulating ______
Immune Complexes
_____are antibodies to antigens found in the cytoplasm of neutrophils.
ANCA
Antineutrophil Cytoplasmic Antibodies
ABs can damage endothelial cells by both antibody-dependent cellular cytotoxicity (ADCC) and complement activation mechanisms.
these ABs directed toward structures on the surface of endothelial cells are NOT found in all vasculitic syndromes.
Antiendothelial antibodies:
antigen-driven vascular inflammation. This polymorphism is not shared by patients with rheumatoid arthritis.
T Cell Dependent Mediated Endothelial Cell Injury
promote binding of IC and PMNs, express MHC class II genes, enhance local lymphocyte proliferation, and release stimulatory and proliferative cytokines.
These changes may promote the vascular inflammatory response and initiate a T cell proliferative response.
Infection of Endothelial Cells
Vasculitis can affect vessels _____
Anywhere
Fever
HA
tenderness on side of head
Older person
Giant Cell
