Ch 3 - Rheumatology: Vasculitides Flashcards
What does Takayasu Arteritis affect?
Large arteries—aorta
Who does Takayasu Arteritis affect?
Asian females
40 years old
What are clinical features of Takayasu Arteritis?
– Erythema nodosum on the legs
– Pulselessness, arm claudication
What does Temporal Arteritis (giant cell arteritis) affect?
Large arteries
Who does Temporal Arteritis (giant cell arteritis) affect?
More common in females >50 years old
What are symptoms of Temporal Arteritis (giant cell arteritis)?
– Tenderness of the scalp and in the muscle of mastication
– Headaches
– Abrupt visual loss in 15% of patients
What is Temporal Arteritis (giant cell arteritis) associated with?
polymyalgia rheumatica
How is Temporal Arteritis (giant cell arteritis) diagnosed?
Elevated ESR
Temporal artery biopsy
What are treatments of Temporal Arteritis (giant cell arteritis)?
High dose steroids ASAP imperative to preventing permanent vision loss
ASA 325 mg daily—improves prognosis
Describe the association of Polymyalgia Rheumatica with temporal arteritis.
16% of PMR patients develop temporal arteritis, and 50% of temporal arteritis patients have PMR symptoms
What are symptoms of Polymyalgia Rheumatica?
– Fever, weight loss, malaise
– Proximal muscles
– Morning stiffness/ muscle tenderness
– Abrupt myalgias/arthralgia
How is Polymyalgia Rheumatica diagnosed?
ESR > 50
What are treatments of Polymyalgia Rheumatica?
Steroids
What is Polyarteritis Nodosa?
Systemic necrotizing vasculitis involving small/ medium-sized arteries
Who is affected by Polyarteritis Nodosa?
2:1 male:female ratio
What are clinical features of Polyarteritis Nodosa?
- Glomerulonephritis—#1 cause of death
- Lungs spared
- Skin—palpable purpura
- Mononeuritis multiplex, arthritis
What disorders are associated with Polyarteritis Nodosa?
- RA
- SLE
- Sjögren’s syndrome
What are types of Anti-neutrophil cytoplasmic Ab (ANCA) associated vasculitides?
Granulomatous vasculitis (Formerly Wegener’s Granulomatosis)
Microscopic Polyarteritis
Churg–Strauss Syndrome
What is affected in Granulomatous vasculitis (Formerly Wegener’s Granulomatosis)?
Small-to-medium-sized artery involvement
Who is affected in Granulomatous vasculitis (Formerly Wegener’s Granulomatosis)?
More common in middle-aged males
What are clinical features of Granulomatous vasculitis (Formerly Wegener’s Granulomatosis)?
• Necrotizing granulomatous vasculitis involving:
– Upper/lower respiratory tract
– Focal segmental glomerulonephritis
• “Saddle-nose” deformity
• Pulmonary, tracheal, ocular, and cutaneous manifestation
What is affected in Microscopic Polyarteritis?
Small-to-medium arteries involved
What are clinical features of Microscopic Polyarteritis?
- Few or no immune deposits seen
* Renal and pulmonary involvement
What is affected in Churg–Strauss Syndrome?
Small-to-medium arteries involved
What are clinical features of Churg–Strauss Syndrome?
• Eosinophil-rich and granulomatous inflammation
• Respiratory tract involvement predominates:
– Associated with asthma, eosinophilia
• Neuropathy common
What are clinical features of Behçet’s Syndrome?
- Small vessels involved
- Oral and genital skin ulcers
- 20% of patients experience venous thrombosis
What are clinical features of Goodpasture’s Syndrome?
Pulmonary and kidney involvement
What is the cause of Goodpasture’s Syndrome?
Abs to glomerular basement membrane
