vasculitis Flashcards
what is vasculitis and how is it categorised
Vasculitis is a histological term describing inflammation of the vessel wall. The inflammation can cause the walls of the blood vessels to thicken, which reduces the width of the passageway through the vessel. If blood flow is restricted, it can result in organ and tissue damage.
Vasculitis is categorised by blood vessel size; small,medium and large.
large - referes to the aorta and its major tributaries
medium - medium and small-sized arteries and arterioles
small - small arteries, arterioles, venules and cappillaries
what causes/patho of Vasculitis
DAMAGED ENDOTHELIUM
damaged endothelium leads to exposed collagen tissue –> increased blood coagulation -> weakened, damaged blood vessel walls –> aneurysms –> vessel wall heals, stiffens as fibrin deposits
AUTOIMMUNE DISEASE
Direct method - body mistakes endothelial layer of blood vessel for foreign pathogen –> attacks
- molecular mimicry: immune system white blood cells mistake normal antigens of endothelial cells for foreign invaders
- medium, large-vessel vasculitides
indirect method - immune system attacks healthy cells near vascular endothelium -> damages endothelial cells - small-vessel vasculitides.
how is vasculitis diagnosed and treated.
blood tests - increase CRP and ESR
imaging tests - CT, MRI and ultrasound
biopsy
treatment
- corticosteroids such as prednisone
- surgery is there is an aneurysm.
large vessel - what is PMR and temporal arteritis
polymyalgia rhuematica - PMR causes a sudden onset of severe pain and stiffness of
the shoulders and neck, and of the hips and lumbar spine; a limb girdle pattern
GCA - GCA is inflammatory granulomatous arteritis of large cerebral arteries which occurs in association with PMR.
Giant Cell Arteritis (GCA):
Primary Symptoms:
- Severe headaches
- Scalp/temple tenderness
- Jaw claudication
- Temporal/occipital artery tenderness and swelling
- Vision loss (in one eye)
- Age: Extremely rare under 50 years old
Polymyalgia Rheumatica (PMR):
Primary Symptoms:
- Severe pain and stiffness in shoulders, neck, hips, and - lumbar spine
- Age: Typically affects individuals over 50 years old
Diagnostic Tests: Diagnosis based primarily on clinical symptoms and response to low-dose corticosteroids
medium sized vessel vasculitis
Kawasaki’s disease - This is an acute systemic vasculitis involving medium-sized vessels, affecting mainly children under 5 years of age. It is very frequent in Japan, and an infective trigger is suspected. It occurs worldwide and is also seen in adults. fever, bilateral conjunctival congestion
buerger’s disease - affects those younger than 45 and male and smokers. with ulceration of digits, ischemic claudication, blood clots in small arteries of fingers, toes. classified by ulcers, dead tissues in extremities.
small sized vessels vasculitis
Churg-Strauss Syndrome - affects small vessels in the kidneys and the lungs, with sinusitis, lung damage, kidney damage.
granulomatosis with polyangiitis - affects small blood vessals located in the nasophayrnx, lungs, kidneys. characterised by chronic pain, saddle nose deformity, breathing difficultys, ulcers with bloody coughing.
Bechets disease
- autoimmune multisystem vasculitis affecting any sized vessel.
- commonly seen in middle east, asian decent
- complications include blindness.
- S/S include - recurrent oral ulcers, genital ulcers, skin papules, decreased vision, headaches, fever, stroke
rheumatoid vasculitis
Rheumatoid vasculitis is a condition which is associated with rheumatoid arthritis in which blood vessels become inflamed
Vasculitis is a serious complication of rheumatoid arthritis. While rheumatoid arthritis affects the body’s joints, vasculitis is a condition in which blood vessels become inflamed. When blood vessels become inflamed, they may become weakened and increase in size, or become narrowed, sometimes to the point of stopping blood flow
