Vasculitides Flashcards
Define vasculitides
Primary vasculitides are classified based on MAIN VESSEL SIZE affected
- Large, medium, small
Define vasculitis
Inflammation & necrosis of blood vessels
Types of vasculitides - large vessel
2
Giant cell arteritis
Takayasu’s aortitis
Types of vasculitides - medium vessel
2
Polyarteritis nodosa
Kawasaki’s disease
Types of vasculitides - small vessel
6
Churg-Strauss syndrome Microscopic polyangiitis Wegner’s granulomatosis Henoch-Schonlein purpura Mixed essential cryoglobinaemia (MEC) Relapsing polychondritis
Aetiology of vasculitides
3
UNKNOWN
Suggested autoimmune origin
Immune complex deposition in the walls of blood vessels leads to inflammation
Risk factors for vasculitides
4
Hepatitis B - polyarteritis nodosa
Hepatitis C - mixed essential cryoglobinaemia
pANCA - microscopic polyangitis & Churg-Strauss
c-ANCA - Wegner’s granulomatosis
Epidemiology of vasculitides
prevalence, Takayasu group
RARE
Takayasu’s arteritis is most common in japanese females
Presenting symptoms & signs of vasculitides - general
2 general + 4
Large vessel vasculitides have a classic clinical pattern based on the vessels affected
Medium & small vessel vasculitides are characterised by multi organ involvement & have less specific clinical features
Fever
Malaise
Night sweats
Weight loss
Presenting symptoms & signs of vasculitides - skin
Rash
Presenting symptoms & signs of vasculitides - joint
2
Arthralgia
Arthritis
Presenting symptoms & signs of vasculitides - GI
3
Abdo pain
Haemorrhage
Diarrhoea
Presenting symptoms & signs of vasculitides - kidney
2
Glomerulonephritis
Renal failure
Presenting symptoms & signs of vasculitides - lungs
5
Dyspnoea Cough Chest pain Haemoptysis Haemorrhage
Presenting symptoms & signs of vasculitides - CVS
3
Pericarditis
Coronary arteritis
Myocarditis
Presenting symptoms & signs of vasculitides - CNS
2
Mononeuritis multiplex
Infarction
Presenting symptoms & signs of vasculitides - eyes
2
Retinal haemorrhage
Cotton wool spots
Presenting symptoms & signs of vasculitides - GCA
4
Loss of vision
Jaw claudication
Headache
Scalp tenderness
Presenting symptoms & signs of vasculitides - polyarteritis nodosa
(5)
Micro aneurysms Thrombosis Infarctions Hypertension Testicular pain
Presenting symptoms & signs of vasculitides - Henoch-Schonlein purpura
(5)
Purpura Arthritis Gut symptoms Glomerulonephritis IgA deposition
Presenting symptoms & signs of vasculitides - Wegner’s granulomatosis
(7)
Granulomatous vasculitis of upper & lower respiratory tract Nasal discharge Ulceration & deformity Haemoptysis Sinusitis Glomerulonephritis Saddle nose
Investigations for vasculitides
6 types
Bloods
Autoantibodies
Urine
CXR
Biopsy
Angiography
Investigations for vasculitides - bloods
2
FBC - normocytic anaemia, high platelets, high neutrophils
High ESR/CRP
Investigations for vasculitides - autoantibodies
e.g. cANCA in Wegner’s
Investigations for vasculitides - urine
3
Haematuria
Proteinuria
Red cell casts (if glomerulonephritis)
Investigations for vasculitides - CXR
2
Diffuse, nodular or flitting shadows
Atelectasis
Investigations for vasculitides - biopsy
3
Renal
Lung
Temporal artery (in GCA)
Investigations for vasculitides - angiography
To identify aneurysms (in PAN)
