Rheumatology: Vasculitis Flashcards
What is vasculitis?
An inflammatory blood vessel disorder
What questions are important in a Hx when considering vasculitis?
- Ask about Raynaud’s
- Musculoskeletal: arthralgia, myalgia, proximal muscle weakness
- CNS/PNS: headaches, visual loss, tinnitus, stroke, seizure, encephalopathy
- Nose bleeds, crusts, ulcers and oral ulcers
- Heart/lung: pericarditis, cough, chest pain, hemoptysis, dyspnea
- GI: abdominal pain
- Renal: Haematuria
- Limbs: Neuropathy, digital ulcers/ischaemia
What physical examinations should be performed when investigating vasculitis?
Vital signs: blood pressure (hypertension) and pulse (regularity and rate)
Skin: palpable purpura, livedo reticularis, nodules, digital ulcers, gangrene, nail bed capillary changes
Neurologic: cranial nerve exam, sensorimotor exam
Ocular exam: visual fields, scleritis, uveitis episcleritis
Cardiopulmonary exam: Crackles, pleural rubs murmurs, arrhythmias
Abdominal exam: tenderness, organomegaly
How should vasculitis be Ix?
Urine dip/microscopy - glomerulonephritis
FBC, U&Es, LFTs, CRP, PV, ESR,
Specific serology: ANA, ANCA, RF
Complement levels C3, C4
Hepatitis screen for B and C, HIV
Cryoglobulins
Serum and urine protein electrophoresis
Outline how vasculitis be managed?
General Measures: Rule out infection, stop offending drug in secondary causes
1st line: Corticosteroids
2nd Line: Cytotoxic medications, immunomodulatory, or biologic agents (cyclophosphamide methotrexate, azathioprine, leflunomide mycophenolate mofetil, rituximab, IVIG)
