Vasculitis Flashcards
Define vasculitis
Inflammation of blood vessels
What does inflammation of blood vessels lead to?
Thickening, stenosis, occlusion with ischaemia and necrosis
What can cause secondary vasculitis?
Drugs, toxins, infection, disease
How is vasculitis classified?
Large vessel
Medium vessel
Immune complex small vessel
ANCA positive small vessel
What are the two types of large vessel vasculitis?
Takayasu and Giant Cell
What are the two types of medium vessel vasculitis?
Polyarteritis nodosa and kawasaki disease
What are the three types immune small vessel vasculitis?
Cryoglobulinemic vasculitis
IgA vasculitis
Hypocomplemtemic urticarial vasculitis
Name the ANCA positive small vessel vasculitis’s
Granulomatous with polyangitis
Eosinophilic granulomatosis with polyangitis
What is meant by the term large vessel vasculitis?
Granulomatous inflammation of aorta and major branches
Describe the epidemiology of Takayasu arterities
Common in eat asian countries usually patients <50 years old
Describe the epidemiology of Giant Cell arterities
Associated with polymyalgia rheumatica patients >50 years old
What vessels are commonly affected in giant cell arteritis?
Cranial/temporal/ophthalmic/facial arteries
What are the early features of large vessel vasculitis?
Fever Malaise Night Sweats Weight loss Arthralgia Fatigue Headache (temporal) Blindness (ophthalmic)
What happens in the late stages of large vessel vasculitis?
Claudication - stenosis - aneurysms
What are the clinical signs of late stage large vessel vasculitis?
Reduced pulse and bruits
How is large vessel vasculitis diagnosed?
ESR, PV and CRP will be elevated
MR angiography shows thickened vessel wall and stenosis
PE CT scan
Ultrasound
How is large vessel vasculitis treated?
40-60mg Prednisolone gradually reduced
What are the clinical features of small vessel vasculitis?
- fever and weight loss
- raised non-blanching rash
- arthralgia/arthritis
- mononeuritis multiplex
- glomerulonephritis
- lung opacities
What is another name for eosinophilic granulomatosis with polyangitis?
Chung-Strauss
Describe eosinophilic granulomatosis with polyangitis
Characterised by late onset asthma, rhinitis and eosinophilia. Commonly presents with neurological symptoms e.g neuritis multiplex
What is another name for granulomatosis with polyangiitis?
Wegener’s
Describe granulomatosis with polyangitis
Inflammation involving the respiratory tract and necrotising vasculitis. Common causes ENT and respiratory symptoms e.g haemoptysis and saddle nose
How does microscopic polyangiitis often occur?
Common complication of glomerlonerphitis
What investigations are carried out for small vessel vasculitis?
ESR, CRP and PV Full blood count and U/Es ANCA Urinalysis (assesses renal involvement) CXR Biopsy
What is ANCA?
Anti-neutrophilic cytoplasmic antibody - B cells produced antibodies to neutrophils
How is small vessel vasculitis treated?
IV Steroids and Cyclophosphamide
What is Henoch Schnlein Purpura?
Acute IgA mediated disorder characterised by vasculitis involving; skin, GI tract, kidneys, joints, lungs, CNS
How does Henoch Schnlein Purpura present?
Purpuric rash over the bum and lower limbs
Abdominal pain
Vomitting
Joint pain
Who is commonly affected by Henoch Schnlein Purpura and how is it treated?
Children with a history of upper respiratory tract infection - self limiting settles in a few weeks
