Vasculitides

Question 1

Define Vasculitides

Answer 1

Inflammation and necrosis of the blood vessels

Question 2

What are the causes of small vessel Vasculitides

Answer 2

Behçet’s

Granulomatosis with polyangiitis (Wegener’s)

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)

Microscopic polyangitis

Henoch-Schönlein purpura

Goodpasture’s

Question 3

What are the causes of medium vessel Vasculitides

Answer 3

Polyarteritis nodosa

Kawasaki’s disease

Question 4

What are causes of large bessel Vasculitides

Answer 4

Giant cell arteritis
Polymysalgia rheumatica

Takayasu’s arteritis

Question 5

Describe Behçet’s disease (RF, epidemiology)

Answer 5

RF: HLA-B51

More common in Mediterranean e.g. Greece, Cyprus

Question 6

Symptoms and signs of Behçet’s disease

Answer 6

Triad:
Recurrent oral ulcers
Genital ulcers
Uveitis

Rash, arthritis, pericarditis, colitis

Question 7

Symptoms and signs Granulomatosis with polyangiitis

Answer 7

(Wegener's)
Triad:
 - URT symptoms (rhinitis, nose bleed)
 - LRT symptoms (haemoptysis)
 - Glomerulonephritis -> Haematuria 

Sore eye, ear, joints, gangrene

Saddle nose

Question 8

Symptoms and signs of Eosinophilic granulomatosis with polyangiitis

Answer 8

Tri-phasic

1. Allergic - asthma/rhinitis
2. Eosinophilic - tissue damage in lung and GIT
3. vasulitic - widepsread organ damage and death

Haemoptysis, rash, focal neuropathy, kidney damage

Question 9

Symptoms and signs of Microscopic polyangitis

Answer 9

Rapidly progressing glomerulonephritis

Pulmonary haemorrhage -> haemoptysis

Question 10

Investigations to distinguish between the different small vessel Vasculitides

Answer 10

Behçet’s disease - Clinical diagnosis. Can do pathergy test (needle prick -> inflamed and sterile pustule within 48h)

GwP - cANCA

EGwP - pANCA

Microscopic polyangitis - pANCA

Question 11

Describe polyarteritis nodosa (cause, associations, investigations)

Answer 11

Idiopathic
Associated with hepatitis B infection
Can affect any age
Rosary sign seen on angiography

Question 12

Symptoms and signs of polyarteritis nodosa

Answer 12

Constitutional symptoms
Skin rash 
Abdominal pain
Rectal bleeding
Peripheral neuropathy

Question 13

Describe Takayasu’s arteritis

Answer 13

Seen in young-middle-aged Asian/Japanese women
Affects the aorta and its branches
Usually constitutional upset
Absent/weak upper/lower limb pulses and claudication
Tenderness over affected arteries

Question 14

Describe Kawasaki’s disease

Answer 14

Age <5 years

Fever >5 days
Skin rash
Fissured lips
Red swollen palms and soles

Question 15

Describe Henoch-Schönlein purpura (HSP)

Answer 15

IgA vasculitis

Purpura on leg and buttocks
TRIAD
	1. Purpuric rash on buttocks and extensors of lower limbs 
	2. Abdominal pain 
	3. Arthralgia
(oedema)