Systemic Vasculitis Flashcards
1
Q
What is it?
A
Inflammation of blood vessels
Rare but should be considered if patient presents with multiple symptoms
Can be primary or secondary
2
Q
What symptoms are indicative of SV?
A
General
- weight loss
- fever
- malaise
- myalgia
- arthralgia
Skin
- palpable purpura
- ulceration
GI
- mouth ulcers
- abdo pain
- diarrhoea
Resp
- haemoptysis
- dyspnoea
ENT
- epistaxis
- crusting
Cardiac- chest pain
Neuropathies
3
Q
What is the classification of vasculitis?
A
Large arteries
- GCA
- Takayasu’s arthritis- young adults, upper limb claudication and stroke
Medium arteries
- Classic polyarteritis nodosa- multisystemic symptoms and microaneurysms on angiography
- Kawasaki- fever, rash, lymphadenopathy and palmar erythema in children
Medium arteries/small vessels (ANCA positive)
- Wegeners granulomatosis
- Churg strauss syndrome
- microscopic polyangiitis
Small vessels
- HSP
- Cryoglobulinaemia
4
Q
What investigations are needed?
A
Bedside
- Urine dip- renal involvement as determines prognosis
- BP=essential
Bloods
- FBC- leukocytosis in primary disease/infection
- LFTs- hep is secondary cause
- Inflammatory markers
- C-ANCA associated with wegeners
- p-ANCA assocaited with churg strauss and microscopic polyangiitis
Tissue biopsy to confirm diagnosis
5
Q
What is the management?
A
Depends on size of vessel involved
Corticosteroids=mainstay
-reduce dose over 12 months
-IVIG for kawasaki
-Cyclophosphamide often used in ANCA positive disease to induce remission- can cause infertility
Plasma exchange in life threatening conditions
