Vasculitis Flashcards
What is vasculitis?
Name of inflammation of blood vessels
How is vasculitis categorized?
On whether small, medium or large vessels are affected
Types of vasculitis which affects small vessels?
- Henoch-Schonlein purpura
- Eosinophilic granulomatosis + polyangitis
- Microscopic polyangitis
- Granulomatosis + polyangitis
What is Eosinophilic granulomatosis + polyangitis AKA?
Churg-Strauss syndrome
Another name for granulomatosis & polyangitis?
Wegner’s granulomatosis
Vasculitis affecting medium vessels?
- Polyarteritis nodosa
- Eosinophilic granulomatosis + polyangitis
- Kawasaki disease
Vasculitis affecting large vessels?
- Giant cell arteritis
- Takayosu’s arteritis
Presnetation of vasculitis?
- Purpura
- Joint & muscle pain
- Peripheral neuropathy
- Renal impairment
- GI disturbance
- Anterior uveitis & sclertis
- HT
- Fatigue, fever, wt loss, anorexia, anaemia
Investigation of vasculitis?
- Inflamm markers (ESR, CRP)
- ANCA
What is the big marker for vasculitis?
ANCA
What does ANCA stand for?
Anti-neutrophil cytoplasmic ABs
How many types of ANCA are there?
2 types
p-ANCA
c-ANCA
What is p-ANCA associated with?
Microscopic polyangitis + Churg Strauss syndrome
c-ANCA associated with?
Wegner’s granulomatosis
Usual treatment of vasculitis?
Steroids
Immunosuppression
What type of steroids do you use for vasculitis?
Oral (prednisolone)
IV (Hydrocortisone)
Nasal spray
What is Henoch-Schonken Purpura (HSP)?
IgA Vasculitis
Who usually gets HSP?
Children under 10 years
Why does inflammation occur in HSP?
Due to IgA deposits in blood vessels of organs affected (skin, kidneys, GI tract)
What is HSP triggered by?
Upper airway infection or gastroenteritis
What is the rash in HSP caused by?
Inflammation & leaking of blood from small blood vessels under skin= purpura
Presentation of HSP?
- Purpuric rash affecting lower limbs & buttocks on children
- Joint pain
- Abdo pain
- Renal involvement
- IgA nephritis
Management of HSP?
Supportive- analgesia, rest, hydration
What is eosinophilic Granulomatosis with polyangitis?
- Used to be called Churg-Strauss syndrome
- Small/medium vessel vasculitis
Features of eosinophilic granulomatosis with polyangitis?
- Skin & lung problems
- Severe asthma in late teenager
- Elevated eosinophil levels on FBC
What is Wegner’s granulomatosis?
- Small vessels
- Affects resp tract & kidneys
Features of Wegner’s granulomatosis?
- Commonly caused by nose bleeds & crusting nasal secretions
- Hearing loss & sinusitis
- Saddle shaped nose
- Cough/wheeze & haemoptysis
- CXR showing consolidation may be misdiagnosed as pneumonia
- Kidneys: can cause rapidly progressive glomerulonephritis
What does polyarteritis Nodosa affect?
Affects vessels in skin, GI, kidneys and heart
Medium vessels
What is polyarteritis nodosa associated with?
Hep B
-Can also be idiopathic or with Hep C or HIV
Features of polyarteritis nodosa?
Stroke
MI
Renal impairment
Livedo reticulans
What is livedo reticulans?
Mottled, purplish, lace like rash
What does Kawasaki disease affect?
Medium vessels
Who is affected by Kawasaki disease?
Young children under 5 ears old
Presentation of Kawasaki disease?
- Persistent high fever
- Bilateral conjunctivitis
- Erythematosus rash
- Erythema & desquamation of palms & soles
- STRAWBERRY TONGUE
Complication of Kawasaki disease?
Coronary artery aneurysms
Management of Kawasaki disease?
Aspirin
IV Immunoglobulins
What is takoyasus arteritis?
Large vessel vasculitis
Mainly affect saorta and branches + pulmonary arteries
What is Takoyasus AKA?
Pulseless disease (vessels can swell and form aneurysms
How does pulseless disease present?
Before 40
Non-specific symptoms such as fever, malaise, muscle aches,
Specific: arm claudication, syncope
Investigations for Takoyasus arteritis?
CT
MRI angiography
Doppler US of carotids can be useful
