Vasculitis Flashcards
rx ANCA vasculitis
2 doses of rituximab
also steroids and azathioprine
how to treat pulmonary haemorrhage in vasculitis
plasma exchange (removes immunoglobulins that are attacking the blood vessels) steroids
causes of small vessel vasculitis
HSP wegener's (granulomatosis with polyangiitis, GPA) eosinophilic GPA (churg strauss) microscopic polyangiitis SLE
causes of medium vessel vasculitis
polyarteritis nodosa (PAN) kawasaki GCA RA SLE
causes of large vessel vasculitis (aorta, temporal artery)
kawasaki
RA
GCA
takayasu’s arteritis
rx
STEROIDS
what classification system is used
Chapel Hill (classifies based on sx and size of vessel affected)
what vasculitides are ANCA positve
some small ones
wegener’s
microscopic polyangitis
churg-strauss
life threatening feature of vasculitis? what ones?
pulmonary haemorrhage small vessel (e.g. wegener's and churg-strauss)
how to treat pulmonary haemorrhage due to vasculitis
steroids!
plasma exchange! (like dialysis just for the plasma - removes immunoglobulins that are attacking the blood vessels)
why is vasculitis related to nephrology
many pts end up with ESKD and are on dialysis
systemic and joint sx of vasculitis
Systemic: fever, weight loss, fatigue, aching
Joints: range from bad arthritis to aching joints
how do vasculitides cause injury
haemorrhage
ischaemia
thrombosis
classic rash in vasculitis
"palpable purpura" purpuric raised non-blanching? usually on legs
pulmonary and renal sx of vasculitis
Resp: cough (particularly haemoptyisis), SOB -> pulmonary haemorrhage!! (scary)
Kidneys: AKI, haematuria, proteinuria
neuro sx vasculitis
headache, stroke, shooting arm and leg pain, numbness, weakness
nose and ear sx vasculitis
Nose and ears: congestion, hearing loss, inflammation of the nasal septum, sometimes resulting in a perforation or collapse of the bridge of the nose, as shown in the picture below
sign in PAN (polyarteritis nodosa)
small aneuerysms strung like beads of a rosary “rosary sign”
PAN associated with what infecftions
hep b and c
most common symptoms in behcet’s disease
CLASSIC TRIAD
v v painful mouth and genital ulcers. RECURRENT
uveitis
arthritis
sometimes also have skin lesions incl erythema nodosum
(NB is a multisystem disease)
behcet’s commonly seen in
men of turkish origin
what is the pathergy test in behcet’s
minro skin trauma induces inflammatory pustule after 24-48 hrs
rx behce’ts
topical steroids
may require systemic rx
