VASCULITIDES

Question 0

How do classify vasculitides?

Answer 0

Predominantly large vessel

• GCA
• Takayasu’s arthritis

Predominantly medium vessel

• polyarthritis nodosa
• Kawasaki
• rheumatoid

Predominantly small vessel

• ANCA: wegeners granulomatosis, microscopic polyangitis, churg-Strauss syndrome
• HSP, hypersensitivity, cryoglobulinaemia, good pastures syndrome

Question 1

What are vasculitides?

Answer 1

Group of disorders characterized by destructive inflammation in blood vessels.

Question 2

What specific investigations would you do?

Answer 2

CBE EUC LFT
Hepatitis serology 
Urine MCS
ANCA
- cytoplasmic ANCA
- peri nuclear ANCA
Complement
ANA

Question 3

Symptoms of wegeners granulomatosis?

Answer 3

Affects rough 50y/o men

Eyes - orbital masses, scleritis, conjunctivitis

Nasal (90%) - crusting, bleeding, obstruction

MSK - migratory oligoathritis, arthralgia

Renal - rapidly progressive glomerulonephritis -> ESRD (if not treated)

Question 4

Rx for vasculitides?

Answer 4

Large vessel: High dose corticosteroids

Medium/small vessel: Steroids and IV Cyclophosphamide (chemotherapy drug)

Question 5

What is polyarteritis nodosa? What’s it associated with? What investigation changes?

Answer 5

Necrotizing Vasculitis causing aneurysms and thrombosis.

Associated with Hep B

Mild eosinophilia, increased WCC, anaemia, raised ESR, CRP, ANCA -ve

Question 6

What is microscopic polyangitis?

Answer 6

A small vessel Vasculitis causing rapidly progressive glomerulonephritis, pulmonary haemorrhages.

P- ANCA +ve.

Question 7

What is wegeners associated with?

Answer 7

Rapidly progressive glomerulonephritis and pulmonary granulomas

Question 8

What is churgs Strauss associated with?

Answer 8

ATOPY

Question 9

What is cryoglubinaemia associated with?

Answer 9

Hep c (90%)

Levido reticularis