large vessel vasculitis Flashcards
what is it?
primary vasculitis that causes chronic granulomatous inflammation
what are the 2 categories?
temporal/giant cell
Takayasu
where does it predominantly affect?
aorta and its major branches
what is Takayasu arteritis?
vasculitis of arteries that branch from aortic arch
how does Takayasu clinically present?
fever
malaise
weight loss
fatigue
claudication in arms
difference of bp in extremities
what investigations are used for Takayasu?
bloods
MRI angiogram
what would bloods show for temporal?
raised inflammatory markers (ESR, CRP)
what would MRI angiogram show?
thickened vessel walls and stenosis
what is temporal/giant cell?
vasculitis of carotid artery and its branches
what does it have a strong association with?
polymyalgia rheumatica
how does it present?
unilateral acute temporal headache
jaw claudication
visual disturbances
vision loss
what are the clinical signs?
tender enlarged non-pulsatile temporal arteries
carotid bruit
what is the gold standard investigation?
temporal artery biopsy
what is 1st line investigation?
bloods
what would bloods show?r
raised inflammatory markers
what would temporal artery biopsy show?
skip lesions
what is the overall management for both conditions?
prednisolone
add biphosphate or PPI to stop GI effects
low dose aspirin to reduce risk of stroke or blindness
what is the long term treatment for takayasu?
steroid sparing agents - methotrexate, lefunamide
what is the long term treatment for giant cell?
gradual reduction in steroids
if relapse = lefunamide, methotrexate
