Vasculitis Flashcards
What are the 3 primary criteria of vasculitis?
- Vessel wall necrosis
- Invasion of vessel walls with polymorphonuclear leukocytes
- Fibrinoid deposits on vessel wall
What are 4 secondary criteria of vasculitis?
- Perivascular hemorrhage
- Chronic granulomatous inflammation
- Perivascular fibrosis
- Thrombosis of vessel
What is humoral-mediated vasculitis the result of?
Circulating Ab-Ag immune complexes –> auto-antibodies
What is cell mediated vasculitis the result of?
Lymphocytes and macrophages creating granulomatous reaction
What is the name of the auto-antibody that attacks endothelial cells in vasculitis? What are its two forms?
ANCA (anti-neutrophil cytoplasmic antibodies)
Perinuclear (P-ANCA) and cytoplasmic (C-ANCA)
Define primary vasculitis.
Idiopathic loss of tolerance to self
Define secondary vasculitis.
Occurs in response to infection, tumors, immune complexes, drugs, or toxins
What symptoms present with vasculitis affecting vessels of the skin?
Rash, purpura, ulceration, gangrene
What symptoms present with vasculitis affecting vessels of the nervous system?
Headache, stroke, peripheral nerve dmg
What symptoms present with vasculitis affecting vessels of the airways?
Nosebleeds, pulmonary infiltrates or hemorrhage
What symptoms present with vasculitis affecting vessels of the CV system?
Coronary artery disease, MI, pericarditis, claudication
What symptoms present with vasculitis affecting vessels of the GI system?
pain, bloody stools
What symptoms present with vasculitis affecting vessels of the kidney?
Hematuria, proteinuria, glomerulonephritis, hypertension
What symptoms present with vasculitis affecting vessels of the MS system?
arthralgias, myalgias, myositis
What symptoms present with vasculitis affecting vessels of the eyes?
Redness w/ edema, pain, blindness
What are the large vessel vasculitis diseases?
Takayasu’s disease and giant cell arteritis
What are the middle vessel vasculitis diseases?
Kawasaki’s
What are the small vessel vasculitis diseases?
Granulomatosis with polyangitis (GPA), Hypersensitivity vasculitis
How does vasculitis cause clinical symptoms?
Inflammation leads to endothelial injury and vasospasm that contribute to thrombosis and downstream ischemia
How are forms of vasculitis currently classified?
By caliber of vessels involved
How do corticosteroids treat vasculitis?
Binds intracellular hormone receptor and inhibits cytokines
How does Rituximab treat vasculitis?
Anti-CD20 monoclonal antibody - depletes B cells
What cytokine receptors are often blocked as a way to treat vasculitis by preventing recruitment of WBCs and thus inhibiting inflammation?
TNFa and IL-1
In small vessel vasculitis, damage starts ____ and move s____.
Inside, moves out
In large vessel vasculitis, damage occurs _____ and moves ____.
Outside, moves inside
