Vasculitis Flashcards
what is vasculitis
inflammation of the blood vessels
cause of primary vasculitis
an inflammatory response that targets the vessel walls and has no known cause
cause of secondary vasculitis
may be triggered by an infection, a drug, or a toxin and may occur as part of another inflammatory disorder or cancer
give an example of a large vessel vasculitis
giant cell arteritis
what are ANCA-associated small vessel vasculitis
polyangitis
name 2 medium-vessel vasculitis
polyarteritis nodosa
kawasaki disease
who usually gets takayasu arteritis
<40, females, asian
early features of takayasu arteritis
low grade fever, malaise, night sweats, weight loss, arthralgia
late symptom of takayasu arteritis
claudication of upper and lower limbs
what is a complication of untreated takayasu arteritis
vascular stenosis and aneurysms
bloods in takayasu arteritis
raised inflammatory markers
imaging for takayasu arteritis
CT angiogram shows thickened vessel walls and stenosis
what is the most common cause of vasculitis in adults
giant cell arteritis
who usually presents with giant cell arteritis
> 50
what does giant cell arteritis have a strong association with
polymyalgia rheumatica
clinical presentation of giant cell arteritis
unilateral acute temporal headache
jaw claudication
visual disturbances/loss
clinical sign of giant cell arteritis
tender enlarged non-pulsatile temporal arteries
bloods in giant cell arteritis
raised inflammatory markers
first line investigation for giant cell arteritis
temporal artery USS
gold standard investigation for giant cell arteritis
temporal artery biopsy
management of giant cell arteritis
prednisolone 40-60mg daily
what is polyarteritis nodosa
medium vessel arteritis
what can cause secondary polyarteritis nodosa
hep B + C
what system is most commonly involved in polyarteritis nodosa and how does it present
renal
hypertension, function impairment
name some other symptoms of polyarteritis nodosa
purpura, ulcers
muscle pain
mononeuritis
abdo pain, diarrhoea
investigations for polyarteritis nodosa
tissue biopsy + angiogram
management of organ threatening polyarteritis nodosa
steroids + cyclophosphamide
management of non-organ threatening polyarteritis nodosa
steroids + azathioprine/methotrexate
what would be an example of a sign that polyarteritis nodosa is organ threatening
renal failure
what is granulomatosis with polyangiitis
granulomatous inflammation affecting small and medium sized vessels
who usually presents with granulomatosis with polyangiitis
35-55, slightly more men
key features of granulomatosis with polyangiitis
nasal symptoms
respiratory symptoms
glomerulonephritis
autoantibody in granulomatosis with polyangiitis
c-ANCA
what is microscopic polyangiitis
necrotising vasculitis of small vessels with few immune deposits
clinical presentation of miscroscopic polyangiitis
necrotising glomerulonephritis
which vasculitis are positive for pANCA
EGPA and MPA
bloods of ANCA-associated small vessel vasculitis
ESR, PV and CRP raised
anaemia common
what is required to make a definitive diagnosis of ANCA-associated small vessel vasculitis
biopsy
management of ANCA-associated small vessel vasculitis
steroids + methotrexate
what is Henoch-Schonlein purpura
IgA vasculitis
who usually presents with Henoch-Schonlein purpura
children 2-11
what is common for setting off Henoch-Schonlein purpura
preceding infection/ immunisation
clinical presentation of HSP
purpuric rash over bum and lower legs
joint pain
abdo pain
renal involvement
how do we monitor Henoch-Schonlein purpura
urine dipstick for renal involvement
blood pressure for hypertension
management of Henoch-Schonlein purpura
self-limiting
who does polymyalgia rheumatica occur in
> 50
what is polymyalgia rheumatica associated with
giant cell arteritis
clinical presentation of polymyalgia rheumatica
proximal myalgia of hip and shoulders with morning stiffness >45 mins
usually symmetrical
pain worse with movement
clinical signs of polymyalgia rheumatica
reduced movement of shoulders, neck and hips
normal muscle strength
upper arm tenderness
carpel tunnel
management of polymyalgia rheumatica
prednisolone 15mg daily
gradual reduction over 18 months
