Vasculitis Flashcards
Symptoms of Giant cell Arteritis
Unilateral headache, temporal artery tenderness and Jaw Claudication, Can lead to Blindness (if ophthalmic A occluded)
Which disease is associated with Giant Cell Arteritis
Polymyalgia Rheumatica
which arteries are affected in Giant cell arteritis
Branches of Carotid Artery
Histology of Giant cell arteritis
Focal Granulomatous Inflammation
How to treat Giant cell arteritis
High dose corticosteroids
Symptoms of Takayasu arteritis
- weak upper extremity pulse (pulseless disease)
- fever, night sweats
- Arthritis, myalgia
- skin nodules
- ocular disturbances
Histology of Takayasu
Granulomas (in aortic arch and proximal great vessels)
how to treat Takayasu
corticosteroids
where do you see elevated ESR
Giant cell arteritis and Takayasu
Symptoms of Buerger disease
- Intermittent claudication
- Gangrene, Autoamputation of digits
- Superficial nodular phlebitis
- Raynaud phenomenon
Histology of Buerger
Segmental thrombosing vasculitis with vein and nerve involvement (thromboangitis obliterans)
Symptoms of Kawasaki
CRASH and Burn
- Conjunctival injection
- Rash (desquamating)
- Adenopathy (Cervical)
- Strawberry tongue (oral mucositis)
- Hand foot change (edema/erythema)
- Fever
Complications of Kawasaki
Coronary artery aneurysm that can rupture or get thrombosed
How to treat Kawasaki
IV immunoglobulin and Aspirin
Symptoms of polyarteritis nodosa
- Fever, weight-loss, headache
- GI (abdominal pain, melena)
- HTN, neuro
- Cutaneous eruptions
- Renal damage
- NO lungs
Histology of polyarteritis Nodosa
Transmural inflammation with fibrinoid necrosis
Which radio test u would do for patients with Polyarteritis nodosa
Arteriogram of renal (Innumerable renal micro aneurysms)
What to test for in patients with polyarteritis nodosa
Hep B
Treatment of polyarteritis nodosa
Corticosteroids and cyclophosphamide
Symptoms of Behcet syndrome
Apthous ulcer, Genital ulcer, Uveitis, Erythema nodosum
What viruses Precipitate Behcet
HSV or Parvovirus
Histology of Behcet
Immune complex vasculitis
which serotype is associated with Behcet
HLA-B51
Causes of cutaneous small vessel vasculitis
- Meds (penicillin/cephalosporin/Phenytoin/ Allopurinol)
- Infections (HCV/HIV)
Symptoms of cutaneous small vessel vasculitis
Palpable purpura
Histology of cutaneous small vessel vasculitis
Immune complex mediated Leukocytoclastic vasculitis
Symptoms of Churg-Strauss (Eosinophilic granulomatosis with polyangitis)
- Asthma, Sinusitis
- Skin nodules or purpura
- neuropathy (wrist/foot drop)
- Heart, GI , Kidney (pauci immune glomerulonephritis)
Histology of Churg-Strauss
Granulomatous necrotizing with Eosinophilia
Serotypes in Churg-Strauss
MPO-ANCA/ p-ANCA
Increase in IgE
Symptoms of Wegner (Graulomatosis with polyangitis)
- URT (perforated nasal septum, Sinusitis, Otitis media, mastoiditis)
- LRT (hemoptysis, cough, dyspnea)
- Renal (Hematuria, red cell cast)
Histology of Wegner
necrotizing granuloma
Serology in Wegner
PR3-ANCA / c-ANCA (anti-proteinase 3)
What radiologic test to do in Wegner
CXR (large nodular densities)
How to treat Wegner
Cyclophosphamide and corticosteroids
Symptoms of Henoch-Schonlein pupura
- Follows URT infection
- Palpable purpura on buttocks/legs
Arthralgia - Abdominal pain (associated with intussusception)
Which disease is associated with Henoch-Schonlein pupura
IgA nephropathy (Berger)
Cause of Henoch-Schonlein pupura
IgA immune complex deposits
Tx of Henoch-Schonlein pupura
Supportive , possible corticosteroids
Symptoms of Microscopic polyangitis
Similar to Granulomatosis with polyangitis but WITHOUT nasopharyngeal involvement
No granuloma
Serology of Microscopic polyangitis
MPO-ANCA / p-ANCA (anti-myeloperoxidase)
Tx of Microscopic polyangitis
Cyclophosphamide and corticosteroids
Cause of mixed Cryoglobulinemia
Viral (HCV)
Symptoms of mixed Cryoglobulinemia
- Palpable purpura
- Weakness
- Arthralgia
- may have peripheral neuro and kidney
What are Cryglobulins
Immunoglobulins that precipitate in the Cold
Histology of mixed Cryoglobulinemia
mixed IgG and IgM immune complex depositions