Vasculitis Flashcards
What is vasculitis?
Inflammatory blood vessel disorder
How do clinical features of vasculitis arise?
Damage of blood vessel walls with thrombosis, ischaemia, bleeding and/or aneurysm formation
What should you ask about in a history for possible vasculitis?
- age, gender, ethnicity
- drug history
- family history
- constitutional symptoms
- Glove and sweater approach
- Raynaud’s?
- MSK, CNS/PNS, heart/lung, GI, renal and limb symptoms
What MSK symptoms should you ask about related to vasculitis?
- Arthralgia
- Myalgia
- Proximal muscle weakness
What CNS/PNS symptoms should you ask about related to vasculitis?
- Headaches
- Visual loss
- Tinnitus
- Stroke
- Seizure
- Encephalopathy
What heart/lung symptoms should you ask about related to vasculitis?
- Pericarditis
- Cough
- Chest pain
- Haemoptysis
- Dyspnea
What GI symptoms should you ask about related to vasculitis?
- Abdominal pain
What renal symptoms should you ask about related to vasculitis?
- Haematuria
What limb symptoms should you ask about related to vasculitis?
- Neuropathy
* Digital ulcers/ischaemia
What are the 4 types of small vessel vasculitis?
- Microscopic polyangiitis (MPA)
- Granulomatosis with polyangiitis (GPA)/Wegener’s granulomatosis
- Eosinopholic granulomatosis with polyangiitis (EGPA)/Churg-Strauss syndrome
- IgA vasculitis/Henoch-Schonlein purpura
What are the 2 types of medium vessel vasculitis?
- Polyarteritis nodosa (PAN)
* Kawasaki disease (KD)
What are the 2 types of large vessel vasculitis?
- Takayasu arteritis (TAK)
* Giant cell arteritis (GCA)
What can cause secondary vasculitis?
- Infections
- Drugs
- Malignancy
- CT diseases
What are the diagnostic tests for vasculitis?
- Urinalysis
- FBC, U&Es, LFTs
- CRP, PV, ESR
- Serology - ANA, ANCA, RF
- Complement - C3 and C4
- Hepatitis B and C and HIV screen
- CXR, CT, MRI, arteriography
- Blood cultures, CK, ECG
What is the treatment for vasculitis?
Initially rule out infection and stop any drugs that could be causing it
1st line is corticosteroids
2nd line is cytotoxic medications, immunomodulatory or biologic agents e.g. cyclophospahmide, methotrexate, azathioprine , Leflunomide, mycophenolate mofetil, rituximab, IVIG
