Vasculitides Flashcards
Define Vasculitis?
Vasculitis is the inflammation and necrosis of blood vessels
How are Primary Vasculitides classified?
Based on the MAIN VESSEL SIZE affected
What are the different classifications of Vasculitides?
LARGE
MEDIUM
SMALL
What are the Large Vasculitides?
Giant Cell Arteritis
Takayasu’s Aortitis
What are the Medium Vasculitides?
Polyarteritis nodosa
Kawasaki’s disease
What are the small Vasculitides?
Churg-Strauss syndrome Microscopic polyangiitis Wegner's granulomatosis Henoch-Schonlein purpura Mixed essential cryoglobulinaemia (MEC) Relapsing polychondritis
What is the aetiology of Vasculitides?
Suggested autoimmune origin
Immune complex deposition in the walls of blood vessels leads to inflammation
What are the risk factors for Vasculitides?
Hepatitis B - polyarteritis nodosa
Hepatitis C - mixed essential cryoglobulinaemia
pANCA - microscopic polyangiitis + Churg-Strauss
cANCA - Wegner’s granulomatosis
What is the epidemiology of Vasculitides?
RARE
Takayasu’s arteritis is most common in japanese females
What are the presenting symptoms and signs of Vasculitides?
Large vessel Vasculitides have classic clinical patterns based on the vessels affected (e.g. GCA and loss of vision/headache)
Medium and small vessel Vasculitides are characterised by multiorgan involvement and have less specific clincial features
What are the general possible features of ALL Vasculitides?
Fever
Malaise
Night sweats
Weight loss
What are the possible features of ALL Vasculitides on the skin?
Rash
What are the possible features of ALL Vasculitides on the joints?
Arthralgia
Arthritis
What are the possible features of ALL Vasculitides in the GI?
Abdominal pain
Haemorrhage
Diarrhoea
What are the possible features of ALL Vasculitides in the kidneys?
Glomerulonephritis
Renal failure
What are the possible features of ALL Vasculitides in the lungs?
Dyspnoea Cough Chest pain Haemoptysis Haemorrhage
What are the possible CVS features of ALL Vasculitides?
Pericarditis
Coronary arteritis
Myocarditis
What are the possible CNS features of ALL Vasculitides?
Mononeuritis
Multiplex
Infarctions
What are the possible features of ALL Vasculitides in the Eyes?
Retinal haemorrhage
Cotton wool spots
What are the feature characteristics of Giant Cell Arteritis?
Loss of vision
Jaw claudication
Headache
Scalp tenderness
What are the feature characteristics of Polyarteritis Nodosa?
Microaneurysms Thrombosis Infarctions Hypertension Testicular pain
What are the feature characteristics of Henoch-Schonlein Purpura?
Purpura Arthritis Gut symptoms Glomerulonephritis IgA deposition
What are the feature characteristics of Wegner’s Granulomatosis?
Granulomatous vasculitis of upper and lower respiratory tract Nasal discharge Ulceration and deformity Haemoptysis Sinusitis Glomerulonephritis Saddle nose
What investigations do you do for vasculitides?
Bloods Autoantibodies Urine CXR Biopsy Angiography
What bloods do you do for Vasculitides?
FBC
High ESR/CRP
What do you see specifically on the FBC for Vasculitides?
Normocytic anaemia
High platelets
High neutrophils
What do we look for on Urinalysis for Vasculitides?
Haematuria
Proteinuria
Red cell casts (if glomerulonephritis)
What do you look for on the CXR for Vasculitides?
Diffuse
Nodular or flitting shadows
Atelectasis
What biopsy do we do fro Vasculitides?
Renal
Lung
Temporal artery (in GCA)
Why do we do an Angiography for Vasculitides?
To identify aneurysms (in PAN)
