Vasculitis Flashcards
Vasculitic rash presentation of small vessels
Palpable purpura - do not blanch
Splinter haemorrhages
Urticaria
Purpura
0.3-1 cm
Petechiae
< 3 mm
Ecchymoses
> 1 cm
Medium vessel vasculitis
Ulcers
Nodules
Livedo reticularis
Necrotic lesions
Urine dipstick
Gold standard investigation
Renal involvement is a strong predictor of mortality in ANCA vasculitis and SLE
Causes of vasculitis
Drugs:
- cocaine
- azathioprine
- β lactam abx
- NSAIDs
- allopurinol
Infections
- Meningitis - Neisseria, strep, Hep B&C, HIV
Neoplasia - Non Hodgkin lymphoma, adenocarcinoma
Categories of vasculitis
Infection
Immune complex mediated
ANCA mediated
Cell mediated
Behcet’s Disease
Systemic vasculitis of unknown cause
- Turks, Mediterraneans and Japanese
- Recurrent oral and genital ulceration
- non-erosive large joint oligoarthropathy
- vasculitis
Ix of behcet’s disease
skin pathergy test (needle prick → papule formation)
Wegener’s Granulomatosis
Necrotizing granulomatous inflammation and small vessel
vasculitis with a predilection for URT, LRT and Kidneys
Granulomatosis with polyangiitis
- curvy nose
- chronic sinusitis
- cANCA
Presentation
Renal impairment - deposition of immune complexes causing haematuria and proteinuria
Respiratory symptoms:
- dyspnoea
- haemoptysis
- sinusitis
Systemic symptoms:
- fatigue
- weight loss
- fever
- vasculitic rash
Investigations
Urinalysis Bloods - U+Es - FBC - CRP - ANCA
CXR
Types of ANCA vasculitis
cANCA - granulomatosis with polyangiitis
pANCA - eosinophilic granulomatosis with polyangiitis
- associated with UC, PSC
eosinophilic granulomatosis with polyangiitis - Chaug Strauss
Asthma
Blood eosinophilia
Paranasal sinusitis
pANCE
