vasculitis Flashcards
what are large cell vasculitis?
Takayusa arteritis
giant cell arteritis
what are medium cell vasculitis?
polyarteritis nodosa
Kawarsaki disease
what are small cell vasculitis
granulomatosis with polyangitis
eosinophilic granulomatosis with polyangitis
henoch Schonlein purpura
who is takayusa arteritis most common in?
Japanese females <40
what is takayusa arteritis?
vasculitis of the aorta and its main branches
how does takayusa present?
hypertension
claudication
weak arm pulses
what are you at risk of with takayusa arteritis?
stroke
dissection
what are the symptoms of giant cell arteritis?
bruit (carotid)
blood pressure difference of extremities
temporal arteritis - headache, scalp tenderness, jaw claudication, risk of blindness
what investigation can be done for giant cell arteritis?
temporal artery biopsy
raised inflammatory markers
why by temporal artery biopsy be negative?
skip lesions
how does polyarteritis nodosa (PAN) present?
purpura
punched out ulcers
renal failure
what is polyarteritis nodosa associated with?
hep b
what is Kawasaki disease?
PAN in children
how does Kawasaki disease present?
children with strawberry tongue
how does granulomatous with polangitis (GPA) present?
sadle nose (due to nasal cartilage collapse)
chronic sinusitis
epitaxis
deafness
joint pain
haematuria and proteinuria due to rapid glomerulonephritis
what immunological findings are in GPA?
c-ANCE & PR3 positive
what investigation are done for GPA?
urinalysis (+/- renal biopsy)
how does EGPA present?
late onset asthma
high eosinophil count
sinusitis
mononeuritis multiplex - foot drop
what immunology is seen with EGPA?
p-ANCE & MPO positive
what does microscopic polyangitis typically result in?
rapidly progressive glomerulonephritis
what is the treatment for early/localised vasculitis?
methotrexate + steroids
what is the treatment for generalised/systemic vasculitis?
cyclophosphamide + steroids
plasma exhchange if creatinine >500
what it the treatment for refractory vasculitis?
IV immunoglobulins
rituximab
what is henoch schonlein purpura?
acute IgA mediated diorder
generalised vasculitis of small vessels of skin, GI tract kidney and joints
not associated with ANCA
who is hence schonlein purpura most common in ?
children 2-11
what is often associated with HSP?
URTI/pharyneal infection/GI infection
1-3 weeks before
most commonly strep pyogenes
what are the symptoms of HSP?
non blanching purpuric rash buttock and lower limbs colicky abdo pain bloody diahorrea joint pain/swelling renal involvement
what it the treatment for HSP?
self limiting
usually resolves in 8 weeks
can relapse
hospital admittance for supportive therapy
