Vasculitis Flashcards
What is the mortality rate of untreated small vessel vasculitis ?
90% after two years
What is primary vasculitis?
Autoimmune vasculitis
What is secondary vasculitis?
Vasculitis triggered by an infection, drug, toxin or cancer.
What are the different classes of Vasculitis?
Large-vesselVasculitis
Medium vessle vasculitis
Small-vessel vasculitis:-
ANCA associated small vessel vasculitis
Immune complex small vessel vasculitis
What symptoms are common to all vasculitides?
Fever
malaise
Weight loss
fatigue
What are the two main causes of Large vessle vasculitis?
Takayasu arteritis (TA)
Giant Cell Arteritis (GCA)
Who gets Takayasu arteritis?
Asian woman under 40yrs
Who gets Giant Cel arteritis?
people older than 50.
Increased risk in polymyalgia rheumatica
What is characterisitc of both Takayasu Arteritis and Giant cell arteritis?
Granulomatous infiltration of the walls of large vessels.
What percentage of patients with Giant cell arteritis also have Temporal arteritis?
50%
What are the classic symptoms of this disease?
Temporal Arteritis
Unilateral temporal headache
Scalp tenderness
Jaw claudiaction
Why is there a risk of blindness in people with temporal arteritis?
Due to iscaemia of the optic nerve
What autoimmune disease greatly increase the risk of giant cell arteritis?
Polymyalgia Rheumatica
Whats the problem with a Temporal Artery biopsy
Temporal arteritis has skip lesions. You could miss it
What is the mangement plan for Temporal Arteritis ?
40-60mg of prednisolone
or
methotrexate/azathioprine
What causes Medium vessel vasculitis?
Kawasaki Disease
Polyarteritis nodosa
Who gets Kawaski disease?
Kids under 5yrs
Which vessle is it imporant to pay particular attention to in Kawasaki disease?
Cornary arteries as aneuyrisims can develop
What is Polyarteritis nodosa?
Necrotizing inflammatory lesions that affect arteries at vessel bifurcations resulting in microaneurysms.
Where in the body does Polyarteritis nodosa usually have an effect?
Skin
gut
kidneys
What are the two classes of Small vessel Vasculitis?
ANCA associated Vasculitis
ANCA negative Vasulitis
study this
Who gets Granulomatosis with Polyangiitis?
Northern Europeans
male - female 1.5 - 1
any age but typically 35-55
How does Eosinophilic granulomatos with Polyangitis compare to Granulomatosis with polyangiitis
In eosinophilic granulomatosis with polyangitis you will find the presence of late onset asthma and a high eosinophil count
What tests can you do to diagnose Temporal Arteritis?
Biospy - beware of skip lesions
What is a buzzword for granulmoatosis with polyangiitis?
Weight loss with ENT problems
What must you always check for in suspected vasculitis ?
Renal Function tests
What would you look for/find in the blood tests in a patient with Giant cell arteritis?
Raised ESR
Raised plasma viscosity
Raised CRP
What would you do if a patient came in and you suspected Temporal Arteritis?
Start Prednisolone 40-60mg
Reffer for a biopsy
Check renal function
Who gets this and Why?
People with Granulomatosis with Polyangiitis (GPA)
Ischeamia of the cartilage resulting in saddle nose.
What 4 things are classic of granulomatosis with polyangiitis?
- Nasal or oral inflammation- ulcers
- Nodules, fixed infiltrates or cavities on CXR
- Microhematuria
- Gramulatomous inflammation of artery walls
