Vasculitis Flashcards
what conditions are covered in ANCA vasculitis
GPA, EPGA, MPA
common features of ANCA vasculitis (5)
renal, resp (haemoptysis), fatigue + fever, rash, sinusutus
renal symptoms ANCA
immune glomerulonephritis –> creatine, haematuria + proteinuria
first line invx ANCA
urinalysis // bloods, U+E, CRP, ANCA // CXR
which vasculitis + target is GPA
cANCA + anti-PR3
which vasculitis + target is EGPA
pANCA + MPO
what other condition is pANCA usually positive in
UC
distinguishing features GPA
nosebleeds, sinusitis, saddle nose!! glomerulonephtitis, vasculitis rash
invx GPAA (3)
cANCA // CXR // renal biopsy (epithelial crescents)
distinguishing features EGPA
asthma!!! blood eosinophilia!! paranasal sinusitis // polyneuropathy
distinguishing features MPA
no nasopharynx symptoms // renal impairment, rash
which ANCA vasculitis is no granulomatous
MPA
mx ANCA vasculitis (4)
1) steroids 2) cyclophosphamide 3) rituximab 4) plasma exchange + IV Ig
what type of vasculitis is polyarteritis nodusa
medium vessel vasculitis –> necrotizing inflamm –> aneurysm formation
who gets polyarteritis nodusa
middle aged men + hep B
symptoms polyarteritis nodusa
fever, weight loss, arthalgia, hypertension, testocular pain, livedo reticularis, haematuria
what mediates Henoch-Schonlein pupura (HSP) vasculitis
IgA
what disease does HSP overlap with
IgA nephropathy
features HSP
palpable pupuric rash over buttocks and extensors // abdo pain // polyarthritis // haematuria + renal failure
who usually gets HSP
children
what usually precedes HSP
URTI or GI infection
mx HSP
supportive
how is HSP monitored
BP + urinalysis
what are common large vessel vasculitis’
temporal and takayasu’s
what are common medium vessel vasculitis’
polyarteritis nodusa + kawasaki
what are common small vessel vasculitis’
ANCA (GPA, MPA, EGPA) and immune (HSP, goodpastures)
what are common small vessel vasculitis’
ANCA (GPA, MPA, EGPA) and immune (HSP, goodpastures)
what vessel is usually affected in takayus vasculitis
aorta
symptoms takayus vasculitis
absent limb pulse // asian female // headache and malaise // unequal BP // claudication // carotid bruit
what is takayus vasculitis assoc with
renal artery stenosis
invx takayus vasculitis
MR angi or CT angio
mx takayus vasculitis
steroids
who usually gets GCA
elderly
what is GCA assoc with
polymyalgia rheumatica (PMR)
symptoms GCA
go+ // headache // jaw claudication // vision changes // PMR
vision issues in GCA
anterior ischaemic optic neuropathy // swollen + pale disc with blurred margins
invx GCA
inflamm (ESR + CRP) // biopsy
when should mx be started in GCA
as soon as suspected - prior to biopsy
mx GCA with no visual symptoms
high dose pred (40-60mg)
mx GCA with visual loss
IV methylpred –> high dose pred