Vasculitis Flashcards
Examples
Polymyalgia rheumatica
Polyarteritis nodosa
What is Polymyalgia rheumatica
Severe bilateral pain and morning stiffness of the shoulder, neck and pelvic girdle
Pathophysiology of polymyalgia rheumatica
Pain and stiffness results from inflammatory cells concentrating in tissues surrounding affected joints, attacking the lining of the joints
Clinical presentation of polymyalgia rheumatica
Bilateral shoulder/pelvic fiddle aching pain and stiffness for >45 minutes
Epidemiology of polymyalgia rheumatica
1/1,000 in over 50s
Mean onset 70
Diagnostic tests of polymyalgia rheumatica
Bloods - ESR and CRP raised
Ultrasound - of hip and shoulder
Characteristic pathological findings
Treatment of polymyalgia rheumatica
Glucocorticosteroids
NSAIDs very little effect
What is polyarteritis nodosa
Necrotising arteritis of medium/small arteries
Pathophysiology of polyarteritis nodosa
Necrotising arteritis associated with microaneurysm formation, thrombosis and infarction.
Can afffect various organs (not usually the lung, often the kidney)
Clinical presentation of polyarteritis nodosa
Vague symptoms.
Fever, weight loss, headache and myalgia.
Skin can demonstrate lesions; purpura livedoid, subcutaneous nodules
Aetiology of polyarteritis nodosa
Associated with hepatitis B antigenaemia, suggesting a vasculitis secondary to the deposition of immune complexes
Epidemiology of polyarteritis nodosa
3/100,000 per year
Predominantly middle aged men
Diagnostic tests of polyarteritis nodosa
Angiography or biopsy:
Microaneurysms in hepatic intestinal or renal vessels
Treatment of polyarteritis nodosa
Corticosteroids, usually with immunosuppression
Complications of polyarteritis nodosa
Without treatment, hypertension-induced AKI Headache Dementia Psychosis Encephalopathy
