Vasculitis

Question 1

Definition

Answer 1

Inflammatory disorder of BVs walls, causing destruction (aneurysm/rupture) or stenosis

Question 2

Epidemiology

Answer 2

• affects vessels of any organ
• primary or secondary to any other condition

Question 3

Symptoms

Answer 3

• systemic- fever, malaise, weight loss
• skin- purpura, ulcer, nailbed infarct
• eyes - visual loss
• ENT- deafness
• CNS
• GI/renal

Question 4

Classification

Answer 4

• small vessel
  
  • microscopic polyangitis
  • wegners granulomatosis
• medium vessel
  
  • polyarteritis nodosum
  • kawaski
• large vessel
  
  • giant cell arteritis
  • takayasus

Question 5

Investigations

Answer 5

• ANCA +ve
• ESR/CRP
• urine proteinuria

Question 6

Small vessel disease

Answer 6

Microscopic polyangitis

• P-anca positive​
• rapidly progressing GN

Wegners

• C-ANCA positive
• GN

Question 7

Medium vessel vasculitis

Answer 7

Polyarteritis nodosa

• hepatitis B infection
• vasculitis causes aneurysm and thrombosis in medium arteries
• pus and predoinat skin rash

Hep B treatment, corticosteroids, BP control

Kawaski

• childern <5y
• aneurysm in 40% leads to sudden death

Aspirin and high dose gamma globulin

Question 8

large vessel disease

Answer 8

Giant cell arteritis

• cranial and tempral arteries
• headache, temporal arterys, scalp tenderness
• jaw clauditcation

Steroids, Increased ESR, temporal biopsy

Takayasus

• <55 years
• aorta and branches
• arm claudication and pulses branches

angiography

Question 9

Mangement

Answer 9

large vessles - steroids

medium vessels - steroids + IV cyclophosphamide (aziothiprine as steroid sparing agent)