vasculitic syndromes Flashcards
Raynaud phenomenon- Eti
Paroxymal digital ischemia, exaggerated response of arterioles to stress or cold
Raynaud phenomenon- Primary V Secondary
Primary- appears between 15-30 in women, mildly progressive.
symmetric involvement, spasms, no digital pitting, ulceration or gangrene
Secondary- unilateral, pitting & ulceration, gangrene of digits
Raynaud phenomenon- Sx
Paroxysmal bilateral digital pallor & cyanosis followed by rubor, paresthesia, pain and swelling
Raynaud phenomenon Dx
RF serology
Raynaud phenomenon- Tx
Calcium channel blockers- nifedipine or amlodipine
Giant Cell Arteritis- Eti
> 50 yrs old, more common in N. Europeans
Giant Cell Arteritis- Sx
Pain and stiffness in shoulder and pelvic girdle, fever, malaise, weight loss, headache, jaw claudication, visual abnormalities
Giant Cell Arteritis- Dx
Elevated ESR, temporal artery biopsy
Giant Cell Arteritis- Tx
High dose predinsone, aspirin
Takayasu arteritis- Eti
granulomatous vasiculitis of aorta and major branches. Women during reproductive years, Prevalent in far east. Large vessel vasculties
Takayasu arteritis- Sx
Absent pulse, Bruits, limb claudication, unequal BPs, FUO
Takayasu arteritis- Dx
MRI- inflammatory thickening of vessel walls or CT- stenosesis, occlusions
Takayasu arteritis- Tx
Corticosteroids- x months
Polyarteritis nodosa- Eti
Medium sized artery necrosis, confined to arterial vasculature, associated with Hep B
Polyarteritis nodosa- Sx
Constitutional symptoms, pain in extremities, vasculitic nephropathy, malleoli ulcerations
Polyarteritis nodosa- Dx
Tissue biopsy
Polyarteritis nodosa- Tx
High dose gluccocorticoids
ANCA- Eti
Small vessel vasculitis. Glomerulonephritis due to antinuclear antibodies- autoimmune disorder
ANCA- Sx
Systemic inflammatory symptoms- fever, malaise, weight loss, hematuria, protienuria, hemoptysis
ANCA- Dx
Serology
ANCA- Tx
High dose corticosteroids
Behcet syndrome- Eti
Onset around 25-35, rare in N America, prevalent in Asia. Small vessel vasculitis
Behcet syndrome- Sx
Recurrent oral and genital ulcers, seronegative arthritis, eye abnormalities- blindness, follicular rash, palsies- CNS involvement
Behcet syndrome- Dx
Clinical
Behcet syndrome- Tx
Colchicine, Corticosteroids
Wegener granulomatosis- Eti
Small vessel vasculitis. 4th-5th decade of life. Develops over 4-12 months
Wegener granulomatosis- Sx
Triad: Upper & lower respiratory tract disease, and glomerulonephritis.Fever malaise & weight loss.
Wegener granulomatosis- Dx
ANCA antibodies, proteinuria, tissue biopsy
Wegener granulomatosis- Tx
Cyclophosphamide + oral prednisone, methotrexate