Osmosis: Vasculitis Flashcards
what is vasculitis?
inflammation of the blood vessels; usually due to autoimmune disease causing damage against endothelial cells
molecular mimicry = medium and large vessels vs. indirect damage of small vessels damage the endothelium
can happen in veins and arteries
classified by the size of the vessel they effect
what is the progression of vasculitis
damage endothelium exposes underlying collage and TF which increase the chance of blood coagulation and walls are damage = increased aneurysm
as the walls heal, fibrin is deposited = thicker and less flexible vessels which reduces blood flow
what are the symptoms of vasculitis?
- fever
- weight loss
- fatigue
specific symptoms are based on which vessels/organs in the body are effected
treat with corticosteroids
what is giant cell arteritis?
large vessel vasculitis
carotid artery branches vasculitis:
1. temporal = headache
- ophthalmic artery = visual disturbances
- facial artery = pain while chewing
common in women over 50, high ESR
will see giant cells in elastic lamina which separates tinuca intima and media
it’s segmental; only sections of the artery are effected not the whole segment
how do you treat giant cell arteries?
corticosteroids to weaken immune response
high risk of blindness because of poor flow of blood to the eyes via ophthalmic artery
what is takayasu arteritis?
large vessel vasculitis
effects asian women under 40 years old
it effects large areries that branch from the aortic branch
can cause weak or no pulse in upper extremities, visual and neurological symptoms
giant cells in internal elastic lamina and increased ESR
treat with corticosteroids
what is kawasaki disease?
medium vessel vasculitis that effects coronary arteries
what is polyarteritis nodosa?
medium vessel arteries
immune cells attack endothelium because they confuse it for HepB
transmural inflammation and all 3 layers of the vessel die and then heal = fibrinoid necrosis
weakened walls are more prone to aneurysms = string of pearls appearance
renal arteries = hypertension
mesenteric arteries = abdominal pain and GI bleeding
brain artery = neurological symptoms
skin = skin lesions
treat with corticosteroids
what is Buerger’s disease?
medium cell arteritis
notorious for causing blood clots in tiny arteries in the fingers and toes which leads to necrotic tissue that often has to be amputated
usually in men 20-40 years old that use tobacco products
what is small vessel vasculitis?
arterioles, capillaries, venules effected
B cells mistakenly target antibodies to granules made by the persons own neutrophils = one immune cell attacks another
the antibodies are called ANCAs and are mainly IgG type
what is granulomatosis with polyangiitis?
small vessel vasculitis
B cells release autoantibody called cANCA which target and bind to a specific neutrophil granule called proteinase 3 –this causes the neutrophil to release oxygen free radicals and damage the nearby endothelial cells which causes vasculitis
GPA effects nasopharynx, lungs and kidneys in middle aged males with granulomas
nose may eventually cave in or curl from ulcers and blood mucus – difficult breathing and blood coughing from lung damage – restricted blood flow to glomeruli means decreased urine production and increased BP from kidney damage
treat with corticosteroids and cyclophosphamide but relapse is common because cANCA is still present
what is microscopic polyangiitis?
small vessel vasculitis very similar to GPA
does NOT effect nasopharynx vessels, only the kidney and the lungs! plus no granulomas in the blood vessel walls like in GPA
you will see pANCA antiobodies against neutrophil granules myeloperoxidase
treat with corticosteroids and cyclophosphamide but relapse is common
what is Churg-Strauss syndrome?
small vessel vasculitis
caused by pANCA antibodies and causes sinusitis, lung damage and kidney damage – also causes GI, skin, nerve and heart damage like medium vessel diseases
often mistaken as allergies or asthma….
increased eosinophils in the blood
granulomas can form like GPA
what is henoch-schonlein purpora?
small vessel vasculitis
doesn’t involve ANCAs; instead elevated IgA antibodies = in mucosal cells in the lungs and GI
IgA directly targets their own endothelial cells because of molecular mimicry which is different from other small vessel vasculitis that cause indirect endothelial damage
symptoms depend on location but common location is butt and legs = purpura, kidney = hematuria, GI = abdominal pain
skin discoloration is palpable = you can feel the blood pumps because the vessel thickens and you can feel the bump
HSP resolves on its own but can reoccur; steroids only if symptoms are severe
