Vasculitis Flashcards
What is vasculitis?
Inflammation of the blood vessels, with ischaemia, necrosis and organ inflammation
What systemic symptoms are associated with vasculitis ?
Fever
malaise
Weight loss
Fatigue
What are the two main types of large vessel vasculitis?
Takayasu arthritis (TA) Giant Cell arthritis (GCA)
What age group mainly get TA and GCA?
TA = under 40's GCA = over 50's
Which of either GCA or TA have granulomatous infiltration of the walls of the large vessels ?
Both of them
What findings would be present in large vessel vasculitis?
Bruit Blood pressure difference of extremities Claudication Carotodynia or vessel tenderness Hypertension
What disease has a high association with GCA?
Polymyalgia rheumatica
What are classic symptoms of Temporal arthritis?
Unilateral temporal headache
scalp tenderness
jaw claudication
What causes the possibility of blindness in temporal arthritis?
ischaemia of the optic nerve
What investigations are there for temporal arhtritis?
ESR plasma viscosity CRP are all raised
MR angiogram
PET CT scan
What is the management for Temporal arthritis?
40-60mg starting dose of prednisolone
Methotrexate or azothiaprine may be used
Give 2 examples of medium vessel vasculitis?
kawasaki disease - under 5’s
Polyartheritis, resulting in microaneurysm formation
What virus does medium vessel vasculitis have an association with?
Hepatitis B
What are some ENT features of vasculitis?
Sinusitis Nasal crusting Epistaxis Mouth ulcers Sensorineural deafness Otitis media and deafness Saddle nose - due to cartilage ischaemia
What respiratory problems may accompany vasculitis?
Pulmonary infiltrates Cough Hemoptysis Diffuse alveolar hemorrhage cavitating nodules on CXR
What cutaneous problems may occur in vasculitis?
palpable purpura
Cutaneous ulcers
What renal problems may occur in vasculitis?
Necrotising glomerulonephritis
Manifests as blood and protein in urine
What nervous system problems may occur in vasculitis?
Mononeuritis multiplex
Sensorimotor polyneuropathy
Cranial nerve palsies
What ocular problems may occur in vasculitis?
Conjunctivitis Episcleritis Uveitis optic nerve vasculitis retinal artery occlusion proptosis
What occurs in Eosinophilic granulomatosis with Polyangiitis?
late onset asthma and high eosinophil count
What is Henoch-Schonlein Purpura? (HSP)
An acute immunoglobulin A (IgA) mediated disorder
When do most HSP cases occur?
between the ages of 2-11 years
Infection of what organism often accompanies HSP?
Group A Strep (usually occurs up to 3 weeks before HSP)
How does HSP present?
Purpuric rash typically over buttocks and lower limbs Colicky abdo pain Bloody diarrhoea joint pain/swelling Renal involvement (50%)
How do you manage HSP?
Tends to resolvewithin 8 weeks
May relapse
Must perfrom urinalysis to screen for renal problems
