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Vasculitis Flashcards

1
Q

Temporal (giant cell) arteritis epidemiology/presentation

A
  • Generally elderly females
  • Unilateral headache (temporal artery), jaw claudication
  • May lead to irreversible blindness due to opthalmic artery occlusion.
  • Associated with polymyalgia rheumatica
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2
Q

Temporal (giant cell) arteritis pathology/labs

A
  • Large vessel vasculitis
  • most commonly affects branches of carotid artery
  • focal granulomatous inflammation
  • increased ESR
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3
Q

Temporal (giant cell) arteritis Treatment

A

Treat with high-dose corticosteroids

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4
Q

Takayasu’s arteritis epidemiology/presentation

A
  • Asian females <40 years of age
  • “pulseless disease” (weak upper extremity pulses), fever, night sweats, arthritis, myalgias, skin nodules, ocular disturbances
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5
Q

Takayasu’s arteritis Pathology/Labs

A
  • Large-vessel vasculitis
  • Granulomatous thickening of aortic arch, proximal great vessels
  • Increased ESR
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6
Q

Takayasu’s arteritis Treatment

A

Treat with corticosteroids

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7
Q

Polyarteritis nodosa epidemiology/presentation

A
  • young adults
  • hepatitis B seropositivity in 30% of patients
  • fever, weight loss, malaise, headache
  • GI: abdominal pain, melena
  • Hypertension, neurological dysfunction, cutaneous eruptions, renal damage
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8
Q

Polyarteritis nodosa pathology/labs

A
  • Medium-vessel vasculitis
  • Typically involves renal and visceral vessels, NOT pulmonary arteries.
  • Immune complex mediated
  • Transmural inflammation of the arterial wall with fibrinoid necrosis
  • Lesions are of different ages.
  • Many aneurysms and constrictions on arteriogram.
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9
Q

Polyarteritis nodosa Treatment

A

Treat with corticosteroids, cyclophosphamide

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10
Q

Kawaski disease epidemiology/presentation

A
  • Asian children < 4 years of age.
  • fever, cervical lymphadenitis, conjunctival injection, changes in lips/oral mucosa (“strawberry tongue”), hand-foot erythema and desquamating rash.
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11
Q

Kawaski disease pathology/labs

A
  • Medium vessel vasculitis
  • May develop coronary aneurysms -> MI, rupture
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12
Q

Kawaski disease Treatment

A

Treat with IV immunoglobulin and aspirin

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13
Q

Buerger’s disease (thromoangitis obliterans) epidemiology/presentation

A
  • Heavy smokers, males <40 years of age
  • Intermittent claudication may lead to gangrene, autoamputation of digits, superficial nodular phlebitis
  • Raynaud’s phenomenon is often present
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14
Q

Buerger’s disease (thromoangitis obliterans) Pathology/labs

A
  • Medium-vessel vasculitis
  • Segmental thrombosis vasculitis
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15
Q

Buerger’s disease (thromoangitis obliterans) Treatment

A

Treat with smoking cessation

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16
Q

Microscopic Polyangitis Epidemiology/presentation

A
  • Necrotizing vasculitis commonly involving lung, kidneys, and skin with pauci-immune glomerulonephritis and palpable purpura.
17
Q

Microscopic Polyangitis pathology/labs

A
  • Small-vessel vasculitis
  • NO granulomas
  • p-ANCA positive
18
Q

Microscopic Polyangitis Treatment

A

Treat with cyclophosphamide and corticosteroids

19
Q

Wegener’s granulomatosis (granulomatosis with polyangiitis) epidemiology/presentation

A
  • Upper respiratory tract: perforation of nasal septum, chronic sinusitis, otitis media, mastoiditis
  • Lower respiratory tract: hemoptysis, cough, dyspnea
  • Renal: hematuria, red cell casts.
20
Q

Wegener’s granulomatosis (granulomatosis with polyangiitis) Pathology/labs

A
  • Small-vessel vasculitis
  • Triad:
    • Focal necrotizing vasculitis
    • Necrotizing granulomas in the lung and upper airway
    • Necrotizing glomerulonephritis
  • c-ANCA positive
  • Chest X-ray: large nodular densities
21
Q

Wegener’s granulomatosis (granulomatosis with polyangiitis) Treatment

A

Treat with cyclophosphamide, corticosteroids

22
Q

Churg-Strauss syndrome epidemiology/presentation

A
  • asthma, sinusitis, palpable purpura, peripheral neuropathy (ex. wrist/foot drop).
  • can also involve heart, GI, kidneys (pauci-immune glomerulonephritis).
23
Q

Churg-Strauss syndrome pathology/labs

A
  • small-vessel vasculitis
  • Granulomatous, necrotizing vasculitis with eosinophilia
  • **p-ANCA positive, elevated IgE level. **
24
Q

Henoch-Chonlein purpura epidemiolog/presentation

A
  1. Most common childhood systemic vasculitis
  2. Often follows URI
  3. Classic triad:
    1. Skin: palpable purpura on buttocks/legs
    2. Arthralgia
    3. GI: abdominal pain, melena, multiple lesions of same age.
25
Q

Henoch-Schonlein pupura Pathology/labs

A
  • Small-vessel vasculitis
  • Vasculitis secondary to IgA complex deposition.
  • Associated with IgA nephropathy.

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