Vasculitis Flashcards
List 4 types of vasculitis which affect the small sized vessels
- Henoch-Schonlein purpura
- Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss syndrome)
- Microscopic polyangiitis
- Granulomatosis with polyangiitis (Wegener’s granulomatosis)
List 3 types of vasculitis which affect the medium sized vessels
- Polyarteritis nodosa
- Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss syndrome)
- Kawasaki Disease
List 2 types of vasculitis which affect the large sized vessels
- Giant cell arteritis
- Takayasu’s arteritis
List 4 features of a vasculitis
- Purpura
- Joint and muscle pain
- Peripheral neuropathy
- Renal impairment
- GI disturbance (diarrhoea, abdominal pain and bleeding)
- Anterior uveitis and scleritis
- Hypertension
List 4 systemic manifestations of vasculitis
- Fatigue
- Fever
- Weight loss
- Anorexia (loss of appetite)
- Anaemia
Specific test findings for vasculitis
- ANCA (p-ANCA and c-ANCA)
- ↑CRP and ESR
Compare pANCA vs cANCA
p-ANCA (MPO antibodies): Microscopic polyangiitis and Churg-Strauss syndrome
c-ANCA (PR3 antibodies): Wegener’s granulomatosis
What is Henoch-Schonlein Purpura?
An IgA vasculitis that commonly presents with a purpuric rash affecting the lower limbs or buttocks in children (< 10 yrs)
Most common cause of HSP?
Often triggered by an upper airway infection (e.g. tonsillitis) or a gastroenteritis
Four classic features of HSP?
- purpura (100%)
- joint pain (75%)
- abdominal pain (50%)
- renal involvement (50%)
Management of HSP
Supportive ie. simple analgesia, rest and proper hydration
How does Eosinophilic granulomatosis with polyangiitis commonly present?
(Churg-Strauss syndrome)
Presents with severe asthma in late teenage years or adulthood
Most associated with lung and skin problems
Characteristic finding on FBC of Churg-Strauss syndrome
↑ eosinophil levels
Main feature of Microscopic polyangiitis
Renal failure
(can also affect the lungs causing SOB and haemoptysis)
Classic presentation/features of Wegener’s granulomatosis?
(Granulomatosis with polyangiitis)
- Epistaxis and crusty nasal secretions
- Hearing loss and Sinusitis
- Saddle shaped nose due to a perforated nasal septum
- Cough, wheeze and haemoptysis
- Glomerulonephritis
What is Polyarteritis Nodosa?
Medium vessel vasculitis associated with hepatitis B
Associated with a rash called livedo reticularis. - mottled, purplish, lace like rash
What is Kawasaki Disease
Medium vessel vasculitis which affects young children (< 5) with no clear cause
Clinical features of Kawasaki Disease
- Persistent high fever > 5 days
- Erythematous rash
- Bilateral conjunctivitis
- Erythema and desquamation (skin peeling) of palms and soles
- “Strawberry tongue”
Key complication of Kawasaki Disease
coronary artery aneurysms
Treatment of Kawasaki Disease
Aspirin and IV immunoglobulins
What is Takayasu’s arteritis?
Large vessel vasculitis which mainly affects the aorta and it’s branches. It also affect the pulmonary arteries.
These can swell and form aneurysms or become narrowed and blocked which leads to it’s other name of “pulseless disease”
How does Takayasu’s arteritis?
How does Takayasu’s arteritis present?
Before 40 years with:
- Non-specific systemic symptoms: fever, malaise and muscle aches
- Specific symptoms: arm claudication or syncope
How is Takayasu’s arteritis diagnosed
- CT or MRI angiography
- Doppler ultrasound of the carotids can be useful in detecting carotid disease
