Vasculitis Flashcards
What are some symptoms common to vasculitis?
- palpable purpura (non-blanching)
- livedo reticularis (due to dilation of blood vessels)
- urticaria
VERY variable however
What would a blanching lesion indicate?
blood vessel swelling because you can physically push the blood out
What are the two major cause of vasculitis?
- immune mediated inflammation (most)
- direction invasion of vascular walls by infectious pathogens
What else can infections do?
cause a noninfectious vasculitis, by generating immune complexes or triggering a cross-reactive immune response
Immunologic injury in non-infectious vasculitis may be caused by:
- immune complex deposition
- anti-neutrophil antibodies (ANCA)
- antiendothelial cell antibodies
- autoreactive T cells
What are some vasculitis’ that affect large vessels (aorta and its primary branches)?
- temporal (giant cell) arteritis
- Takayasu arteritis
What are some vasculitis’ that affect medium vessels (muscular arteries and supply organs)?
- Polyarteritis nodosa
- Kawasaki Disease
- Buerger disease
What are some vasculitis’ that affect small vessels (arterioles, capillaries, and venules)?
- Wegener’s Granulomatosis
- Mircoscopic polynagiitis
- Churg-strauss syndrome
- Behcet disease
- Henoch-Scholein purpura
- Cyroglobulinemia
How do temporal arteritis (TA) patients present?
- older (50+), white females
- jaw pain when they chew
- ESR often elevated over 100
What is the etiology of TA?
T cell mediated
What is the treatment for TA?
steroids
What is the major complication of TA?
blindness- there is patchy ophthalmic artery involvement. Thus, treatment is started before diagnosis usually
What happens in TA?
- intima thickening, - inflammation of ALL 3 layers of the vessel
Half of patients with TA also have what?
polymyalgia rheumatica
What is polymyalgia rheumatica?
- proximal muscle aches and stiffness
- elevated ESR
- rapid resolution of symptoms with low-dose corticosteroid therapy
What is Takayasu arteritis?
granulomatous vasculitis (like TA- hist looks exactly the same) that classical involves the aortic arch at branch points and is common adults LESS than 50 y/o (primarily young, female Asians)
How do Takayasu arteritis patients present?
- younger than 50 yo
- visual and neurologic symptoms with weak/absent upper extremity pulse
- ESR elevated
Treatment for Takayasu arteritis?
- steroids
- prognosis isn’t that good
How does Polyarteritis nods (PAN) present?
- younger adults
- typically episodic
- systemic inflammation, not localized