vasculitis Flashcards
define vasculitis
inflammation of blood vessels
general presentation of vasculitis
Joint/muscle pain
Peripheral neuropathy
Renal impairment
Purpura
Necrotic skin ulcers
GI symptoms
associated systemic symptoms with general vasculitis
- Fatigue
- fever/night sweats
- weight loss
- anorexia
- anaemia
investigations for general vasculitis
Inflammatory markers high (CRP + ESR)
ANCA is associated with some types - ones that have polyangitis in the name
general treatment for vasculitis
corticosteroids
what are large vessel vasculitis
- giant cell ateritis
- Takayasu’s Arteritis
what are medium level vasculitis
- Polyarteritis Nodosa
- Kawasaki Disease
- buergers disease
what are small level vasculitis
- Eosinophilic Granulomatosis with Polyangiitis
- Granulomatosis with Polyangiitis
- Microscopic Polyangiitis
- Henoch-Schonlein Purpura
what is Henoch-Schonlein Purpura
- an IgA vasculitis
- common in children
- occurs due to IgA deposits in small blood vessels causing inflammation.
what does HSP affect
affects the skin, kidneys, and GI tract.
what triggers HSP
upper airway infection or gastroenteritis
features of HSP
- Purpura
- Joint pain
- Abdominal pain
- Renal involvement (IgA nephritis)
how to manage HSP
- Supportive with analgesia
- Monitor urine dipstick and BP
can HSP cause renal failure
Patients without renal involvement recover in 4-6 weeks, however, the disease can result in renal failure.
what is microscopic polyangitis
a small-vessel vasculitis that mainly affects the kidneys and lungs.
features of MP
- renal failure due to the vasculitis causing glomerulonephritis.
- lso affects the lungs by causing diffuse alveolar haemorrhage, leading to haemoptysis (coughing up blood).
treatment for MP
Usually involves administering corticosteroids (prednisone) to manage the inflammation.
what is Granulomatosis with Polyangiitis
GPA is a small-vessel vasculitis that primarily affects the respiratory tract and kidneys.
what does GPA affect
- Ears –hearing loss
- Sinuses –sinusitis
- Kidneys –glomerulonephritis
- Nose –nose bleeds, crusting in the nose and nasal secretions, saddle-shaped nose, due to nasal bridge collapse.
- lower respiratory tract, it can cause cough, wheeze, and haemoptysis.
treatment for GPA
Corticosteroids
Immunosuppression
what is Eosinophilic Granulomatosis with Polyangiitis
a small-vessel vasculitis that primarily affects the lungs and skin but can affect other organs such as the kidneys.
features of EGPA
presents with severe asthma, sinusitis, and allergic rhinitis.
Raised eosinophils on blood counts is a characteristic finding
treatment of EGPA
Corticosteroids
Immunosuppression (severe cases)
what is Polyarteritis Nodosa
a medium-vessel vasculitis that is caused idiopathically or secondary to an infection (esp. hep B)
features of PAN
Renal impairment
Hypertension
Tender, erythematous skin nodules
Myocardial infarction
Stroke
Mesenteric arteritis (causing intestinal symptoms)
treatment of PAN
Corticosteroids
Immunosuppression (severe cases)
what is KAWASAKI disese
a medium-vessel vasculitis that typically affects children under the age of 5. There is no clear cause.
features of kawasaki disease
- Persistent high fever (>5 days)
- Widespread erythematous maculopapular rash
- Desquamation (skin peeling) of palms and soles
- Bilateral conjunctivitis
- Strawberry tongue
treatment of kawasaki disease
High-dose IV aspirin
IVIG (IV immunoglobulins
what is Takayasu’s Arteritis
a large-vessel vasculitis that mainly affects the aorta and its branches but can also affect the pulmonary arteries.
pathophysiology of takayasus arteritis
The vessels swell and form aneurysms or become narrowed and blocked. Stenosis or occlusion reduces pulses and BP in the limbs, leading to the name or “pulseless disease”.
presentation of takayasus arteritis
usually present before the age of 40 with non-specific systemic symptoms:
Fever
Malaise
Muscle aches
Claudication symptoms (pain and fatigue that worsen using the limb).
treatment of takayasus arteritis
Corticosteroids
what is giant cell artirits
GCA (also known as temporal arteritis) is a medium- and large-vessel vasculitis that has a strong link with polymyalgia rheumatica.
features of GCA
Unilateral headache
Scalp tenderness
Jaw claudication (pain/fatigue/discomfort while chewing)
Blurred/double vision or loss of vision (if untreated)
Tender and inflamed temporal artery
Systemic symptoms (weight loss, fatigue, fever)
Carpel tunnel syndrome
Peripheral oedema
how to diagnose GCA
- Clinical presentation
- Raised inflammation markers (esp. ESR)
- Temporal artery biopsy and ultrasound
treatment of GCA
- Corticosteroids (started immediately, before diagnosis
- Other (if needed) – aspirin, PPI
- Bisphosphonates, calcium/vit
