Vasculitis Flashcards
What is vasculitis?
Inflammation of BVs
What are the 3 vessels it affects?
Large vessel
Medium vessel (musc arteries to organs)
Small vessel (arterioles, venules, capillaries)
What are the diseases which affect large vessels called?
*GCA (Giant cell arteritis) (temporal arteritis)
Takayatsu
What are the diseases which affect Medium vessels called?
*Polyarteritis Nodosa
Buergers disease
Kawasaki disease
What are the diseases which affect small vessels called?
Granulomatosis with polyangitis (GPA) - ‘Wegener disease’
Eosinophilic granulomatosis with polyangitis (EGPA)
Heuloch Schonlein Purpura
General Tx for Vasculitis?
Corticosteroids
What should you consider when steroids given long term?
GI + Bone protection
PPI + Bisphosphonates
GCA
Who does it affect?
50+, caucasian
Sx of GCA?
Unilateral temporal headache, jaw claudication +/- vision change
Scalp tenderness
Pathology of GCA
Affects branches of external carotid
Scalp tenderness = temporal branch
Vision = opthalmic branch
Jaw = facial branch
Dx of GCA?
High ESR +/- CRP (1st line)
Temporal artery biopsy
Diagnostic = granulomatous inflammation of media and intima
Patchy skip lesions therefore take big chunk
Treatment for GCA?
Corticosteroids (prednisolone)
What is a complication of GCA?
Sudden painless vision loss in one eye (optic neuropathy)
Is it temporary or permanent?
Treatment?
Temporary = Amaurosis fugax (loss in 1 or both eyes) - seen in TIA
May be permanent if not dealt with ASAP
High dose IV methylprednisolone
Takayatsu
Who does it affect?
What part of artery does it affect?
Otherwise same as?
Asian/japanese women
mainly affects aortic arch
otherwise same as GCA
Buergers disease
Who does it affect?
Sx?
Kawasaki Disease
In who?
Causes?
Male smokers 20-40
peripheral skin necrosis - thromboangitis obliterates - clots in arteries of fingers and toes
Children, Causes coronary artery aneurysms
Polyarteritis Nodosa
Who is affected?
Associated with?
Which layers of the artery are affected?
Males
Associated with Hep B
Inflammation in all 3 vessel wall layers
Polyarteritis Nodosa Sx?
Severe Systemic Sx
Mononeuritis multiplex (ischemia of vasa nervosum)
GI bleeds (mesenteric artery)
CKD/AKI (renal artery - causes pre renal AKI)
Skin SC nodules + haemorrhage
Diagnosis of Polyarteritis Nodosa
CT angio = needs on string (micro aneurysms)
Biopsy (eg. kidney) - Necrotising vasculitis due to htn
Tx for polyarteritis Nodosa
corticosteroids
Control htn - ACE I
Hep B Tx after corticosteroids
Granulomatosis with polyangitis
It is a cause of?
+ve for?
A cause of glomerulonephritis (+pul Sx)
Saddle shaped nose
cANCA +ve
‘Wegener disease’
Eosinophilic granulomatous with polyangitis
What Is +ve?
‘churg strauss’ disease
pANCA +VE
Heuloch Schonlein Purpura
High what?
High IgA
IgA vasculitis as a DDx for IgA nephropathy
Both present as IgA deposition in GBM on kidney biopsy but HSP has purpuric rash on shins + affects other organs (joints/abdo/renal)
