Vasculitis Flashcards
Treatment of PMR or GCA
Steroids
-If these don’t work then question your diagnosis
-PMR (prednisolone 10-15mg)
-GCA (prednisolone 60-100mg usually in divided doses)
Calcium and Vitamin D supplements are necessary to prevent osteoporosis while high dose steroids are being used
PMR and GCA differential diagnoses
RA, vasculitis, infection, malignancy
Increased frequency of what allele in spondyloarthritis?
HLA-B27
Takayasu arteritis
Giant Cell Arteritis
Large vessel
PAN
Kawasaki’s
Isolated CNS vasculitis
Medium vessel
Churg-Strauss Wegener’s Microscopic Polyangiitis HSP Essential Cryoglobulinemia Hypersensitivity vasculitis Vasculitis 2nd to CTD Vasculitis 2nd to viral infection
Small vessel
PAN
polyarteritis nodosa
ANCA positive
Wegeners (90%)
Microscopic Poly angiitis (70%)
Churg-Strauss (50%)
Drug-Induced (Hypersensitivity)
ANCA negative
HSP
Cryoglobulinemia
Definition of vasculitis
Presence of leukocytes/immune complexes in the vessel wall with reactive damage to mural structures
Anti-PR3 antibodies are highly specific for which condition?
GPA (Wegeners)
ELISA?
Used to help investigate possible vasculitis
If cANCA is associated with MPO but not PR3 then consider different diagnosis such as non-ANCA associated vasculitis e.g. drug induced
If cANCA positive but doesn’t demonstrate PR3 pattern then it is most likely due to the presence of bacterial permeability increasing protein ANCA found in chronic infections e.g. CF, bronchiectasis, subacute bacterial endocarditis, ulcerative colitis
Which medications will cause a large titre of MPO antibodies?
Hydralazine, allopurinol and propylthiouracil can cause a large titre of MPO antibodies
Give an example of a pauci-immune vasculitis
Wegeners (pauci-immune = neutrophils found in vessels)
Give an example of a primary immune vaculitis
HSP
