vasculitis Flashcards
what is giant cell arteritis
inflammation of the temporal artery that can result in blindness due to ischaemic optic neuritis
Takayasu’s is most common in
women > 40 (especially in Japan)
Takayasu’s risk factors
- stroke
- dissection
- aortic valve disease
- ischaemic heart disease
what is Takayasu’s
vasculitis that affects the aorta and its main branches
Takayasu’s pathophysiology
- hypertension
- claudication
- weak arm pulses
- blood pressure differences between extremities
Takayasu’s diagnosis
- increased inflammatory markers
- angiography of the aorta
Takayasu’s management
- oral steroids
- blood pressure control to reduce the risk of stroke
polyarteritis nodosa presentation
- purpura
- punched out ulcers
- renal failure
- associated with hepatitis B
most common artery affected in polyarteritis nodosa
renal artery (causes proteinuria and hypertension)
Kawasaki disease is most common in
kids (childhood version of polyarteritis nodosa)
Kawasaki disease presentation
- strawberry tongue
- dry, red cracked lips
- swollen glands in the neck
- high temperature that lasts for > 5 days
- swollen and red hands and feet
- red eyes
- red inside the mouth and at the back of the throat
granulomatosis with polyangiitis is also known as
Wegner’s
Wegner’s is most common in
men
Wegner’s presentation
- chronic sinusitis
- epistaxis
- nasal crusting
- cough and haemoptysis
- saddle nose (due to nasal cartilage collapse)
- deafness
- joint pain
- haematuria
- proteinuria
Wegner’s diagnosis
- immunology showing cANCA and PR3
- urinalysis
- possible renal biopsy
eosinophilic granulomatosis with polyangiitis is also known as
Churg-Strauss
Churg-Strauss presentation
- late onset asthma
- sinusitis
- mononeuritis multiplex (painful, asymmetrical, asynchronous sensory and motor peripheral neuropathy involving isolate damage to at least two separate nerve areas)
Churg-Strauss diagnosis
- bloods for eosinophilia
- immunology showing pANCA and MPO
what is microscopic polyangiitis
similar to polyarteritis nodosa but affects small vessels
microscopic polyangiitis presentation
rapidly progressive glomerulonephritis
microscopic polyangiitis diagnosis
immunology showing pANCA and MPO positive
vasculitis localised management
- methotrexate and steroids
- azathioprine and steroids
vasculitis early systemic management
- methotrexate and steroids
- azathioprine and steroids
vasculitis generalised management
- cyclophosphamide and steroids
- plasma exchange if CR > 500
- then azathioprine
vasculitis refractory management
rituximab
