Vasculitis Flashcards
Giant cell arteritis is a _______ and mainly affects _____
Medium/ large vessel arteritis
Mainly affects branches of ICA and ECA
What pro-inflammatory cytokines are release in GCA
IL-6 and IL-1
Visual loss in GCA arises from occlusion of which arteries?
Posterior ciliary
Central retinal
Cilioretinal artery
Risk factors for GCA
Age >50, Women
Family history
Other autoimmune conditions
Polymyalgia rheumatica
List 5 main features of GCA
Headache/ Scalp tenderness
Eyes: Visual disturbance/ pain
Jaw/ tongue claudication
Ear: hearing loss/ vertigo
List 5 signs of GCA
Bulging/ knotted artery
Reduced/ absent pulse
Asymmetrical BP of upper limbs
Visual field defects
Abnormal fundoscopy
What is the diagnostic investigation for GCA?
Temporal artery biopsy and histology
Blood test findings for GCA
Anaemia- of chronic disease
Raised CRP and ESR
May show
- Thrombocytopenia
- Elevated liver transaminase
Imaging methods for GCA
Ultrasound
- Temporal/ axillary arteries
PET/ MRA/ CTA
Acute management of a GCA attack with visual symptoms
Analgesia
IV methylprednisolone 500mg-1g for 3 days.
Long term management of GCA
Prednisolone oral
- Load and taper when symptoms resolve
Co-prescribe protection for osteoporosis
Management of resistant GCA
Methotrexate
Biologics
- Tocilizumab
List 4 complications of GCA
Aortic aneurysm
Aortic dissection
Large artery stenosis
CVD (i.e. stroke)
Management of acute GCA without visual loss
40-60mg prednisolone PO
Bechet’s disease is characterised by what triad of features?
Oral ulcers
Genital ulcers
Anterior uveitis
What autoimmune marker is associated with granulomatosis with polyangitis?
c-ANCA
Core presentation of granulomatosis with polyangitis
ELK
ENT
- nosebleeds
- Sinusitis
- (conductive) Hearing loss
Lungs
- Cough
- Haemoptysis
Kidneys
- Haematuria
- Peripheral oedema
Pathophysiology of GPA
ANCA attack endothelial cells.
Sterile granulomas are formed in small blood vessels
What systems are primary affected in microscopic polyangiitis
Kidneys
Lungs
Neurological
microscopic polyangiitis is a (p-ANCA/ c-ANCA) positive condition
p-ANCA
Eosinophilic granulomatosis with polyangitis presentation
Atopy (asthmatic symptoms)
Neurological features
Pulmonary infiltrates
ENT: sinusitis, nasal polyps
GI
- Gut vasculitis
What are the ANCA related vasculitis
Eosinophilic granulomatosis with polyangiitis
Microscopic polyangiitis
Granulomatosis with polyangiitis
Eosinophilic granulomatosis with polyangitis is (p-ANCA/ c-ANCA)
p-ANCA
