Vasculitis Flashcards
How are vasculitides categorised?
Large Vessel Medium vessel Small vesselLarge Vessel Medium vessel Small vesselLarge Vessel Medium vessel Small vessel
Name 2 large vessel vasculitides:
Temporal arteritis
Takayasu’s arteritisTemporal arteritis
Takayasu’s arteritisTemporal arteritis
Takayasu’s arteritis
Name 3 medium vessel vasculitides
Polyarteritis nodosa (PAN)
Kawasaki’s disease
Buerger’s disease (Thrombangitis obliterans)Polyarteritis nodosa (PAN)
Kawasaki’s disease
Buerger’s disease (Thrombangitis obliterans)Polyarteritis nodosa (PAN)
Kawasaki’s disease
Buerger’s disease (Thrombangitis obliterans)
Name 4 small vessel vasculitides
Wegener's granulomatosis Churg Strauss Microscopic polyangitis Henoch Schonlein PurpuraWegener's granulomatosis Churg Strauss Microscopic polyangitis Henoch Schonlein PurpuraWegener's granulomatosis Churg Strauss Microscopic polyangitis Henoch Schonlein Purpura
Define Takayasu’s arteritis
an inflammatory disease of the large arteries. TA particularly affects the aorta, and the pulmonary artery.
BUZZWORD: Pulseless disease. Increased in Japanese womenan inflammatory disease of the large arteries. TA particularly affects the aorta, and the pulmonary artery.
BUZZWORD: Pulseless disease. Increased in Japanese womenan inflammatory disease of the large arteries. TA particularly affects the aorta, and the pulmonary artery.
BUZZWORD: Pulseless disease. Increased in Japanese women
Define Temporal arteritis
the temporal arteries, which supply blood to the head and brain, become inflamed or damaged. It is also known as cranial arteritis or giant cell arteritis.
What are the vascular symptoms in Takayasu’s arteritis?
Absent pulse Bruits ClaudicationAbsent pulse Bruits ClaudicationAbsent pulse Bruits Claudication
What are the symptoms of temporal arteritis?
Scalp tenderness Temporal headache Jaw claudication Blurred visionScalp tenderness Temporal headache Jaw claudication Blurred visionScalp tenderness Temporal headache Jaw claudication Blurred vision
What age are likely to get temporal arteritis?
Elderly
Temporal arteritis has an overlap with:
polymyalgia rheumatica
What is the histology of temporal arteritis?
Increased ESR Granulomatous transmural inflammation Giant cells Skip lesionsIncreased ESR Granulomatous transmural inflammation Giant cells Skip lesionsIncreased ESR Granulomatous transmural inflammation Giant cells Skip lesions
Define Polyarteritis nodosa
a very rare vasculitic disease which affects the medium sized vessels. It can affect any organ in the body but commonly the muscles, joints, intestines, nerves and skin are affected
Although polyarteritis nodosa can affect many organs, which does it spare?
Lungs
Which infection may patients with polyarteritis have (30%)?
Hep B
What can be seen on angiography in polyarteritis nodosa?
Microaneurysms
Define kawasaki disease
a disease in young children with an unknown cause, giving rise to a rash, glandular swelling, and sometimes damage to the heart.
Who does Kawasaki disease affect?
Children
What are the symptoms of Kawasaki disease?
Fever > 5 days
Rash - red palms and soles with later desquamation
Conjunctivitis
Inflammation of lips, mouth or tongue (strawberry tongue)
Cervical LN’s
Coronary arteries may be involved with aneurysm formationFever > 5 days
Rash - red palms and soles with later desquamation
Conjunctivitis
Inflammation of lips, mouth or tongue (strawberry tongue)
Cervical LN’s
Coronary arteries may be involved with aneurysm formation
What can happen to the coronary arteries in Kawasaki disease?
Aneurysm formation
Define Buergers disease
a rare disease of the arteries and veins in the arms and legs. Blood vessels become inflamed, swell and can become blocked with thrombi eventually damaging or destroying skin tissues and may lead to infection and gangrene.
What is a risk factor for Buergers disease?
Heavy smokers
Men
What are the symptoms of Buergers?
Inflammation of arteries of extremities - tibial and radial
Pain
Ulceration of toes, feet, fingersInflammation of arteries of extremities - tibial and radial
Pain
Ulceration of toes, feet, fingers
What can be seen on angiogram with Buergers disease?
Corkscrew appearance from segmental occlusive lesions
Define Wegener’s granulomatosis:
inflammation of small arteries and veins (vasculitis) that classically involves the vessels supplying the tissues of the lungs, nasal passages (sinuses), and kidneys. Wegener’s granulomatosis usually affects young or middle-aged adults.
Wegener’s granulomatosis is a triad of:
1) Upper resp tract: sinusitis, epistaxis, saddle nose
2) Lower resp tract: cavitation, pulmonary haemorrhage
3) kidneys: crescentic, glomerulonephritis1) Upper resp tract: sinusitis, epistaxis, saddle nose
2) Lower resp tract: cavitation, pulmonary haemorrhage
3) kidneys: crescentic, glomerulonephritis
What antibody is positive in Wegener’s granulomatosis?
cANCA (anti-PR3)
What antibody is positive in Churg Strauss?
pANCA (anti-MPO)
What antibody is positive in Microscopic polyangitis?
pANCA (anti-MPO)
Define Churg Strauss
occurs in patients with a history of asthma or allergy and features inflammation of blood vessels in the lungs, skin, nerves, and abdomen.
What conditions predispose churg strauss?
Ashtma
Allergic rhinitisAshtma
Allergic rhinitis
What can be seen on a FBC in churg strauss?
Eosinophilia
Define microscopic polyangitis
Microscopic polyangiitis (MPA) is a small vessel vasculitis which primarily affects the arterioles, capillaries and venule. Since patients with this condition often have a positive blood test known as an antineutrophil cytoplasmic antibody (ANCA), it is also a form of “ANCA-associated vasculitis”. Granulomatosis with polyangiitis (GPA/Wegener’s) is a related condition that shares features with MPA including the presence of ANCA. The cause of MPA is not known. This condition can affect many organ systems in the body including the skin, nerves, lungs gastrointestinal system, lungs and joints. It is a treatable condition and the goal of therapy is to stop further damage to the organs from inflammation in the blood vessels.Microscopic polyangiitis (MPA) is a small vessel vasculitis which primarily affects the arterioles, capillaries and venule. Since patients with this condition often have a positive blood test known as an antineutrophil cytoplasmic antibody (ANCA), it is also a form of “ANCA-associated vasculitis”. Granulomatosis with polyangiitis (GPA/Wegener’s) is a related condition that shares features with MPA including the presence of ANCA. The cause of MPA is not known. This condition can affect many organ systems in the body including the skin, nerves, lungs gastrointestinal system, lungs and joints. It is a treatable condition and the goal of therapy is to stop further damage to the organs from inflammation in the blood vessels.
what is the syndrome within microscopic polyangitis?
Pulmonary renal syndrome:
Pulmonary haemorrhage
Glomerulonephritis
Define Henoch Schonlein purpura
a disorder that causes inflammation and bleeding in the small blood vessels in your skin, joints, intestines and kidneys. The most striking feature of Henoch-Schonlein purura is a purplish rash, typically on the lower legs and buttocks.
What normally preceeds Henoch Schonlein purpura
URTI
Who does Henoch Schonlein purpura effect?
children under 10
What is the pathophys of Henoch Schonlein purpura?
IgA mediated vasculitis
What are the symptoms of Henoch Schonlein purpura?
Palpable purpuric rash (lower limb extensors + buttocks)
Colicky abdo pain
Glomerulonephritis
Arthritis
Orchitis (inflammation of one or both of the testicles)
