Vasculitis Flashcards
Which condition is cANCA positive and associated with anti-PR3?
GPA
How is Henoch Schonlein purpura treated?
This is self limiting, and will settle over weeks-months
GPA can be diagnosed if at least 2 of what 4 features are present?
Nasal/oral inflammation, abnormal chest radiograph, urinary sediment, granulomatous inflammation on biopsy
What are some common symptoms of GCA?
Headache, visual changes, jaw claudication, scalp tenderness
If someone has features of temporal arteritis, what investigation is indicated?
Temporal artery biopsy
What types of imaging may be useful for large vessel vasculitis?
MR angiogram or PET CT
What are some features which vary with disease activity in small vessel vasculitis?
ANCA, anti-PR3, anti-MPO and C3/4
MPA is positive for which type of ANCA?
pANCA
How is large vessel vasculitis treated?
Initially with 40-60mg prednisolone, then DMARDs e.g. methotrexate/azathioprine may be considered
Apart from the rash, what are some other potential features of Henoch Schonlein purpura?
Colicky abdominal pain, vomiting and joint pain/swelling
Who is Takayasu arteritis most commonly seen in?
Usually females aged < 50, often Asian origin
Which vessels are most commonly involved in Takayasu arteritis?
Aorta, femoral and subclavian arteries
What investigations should be used for diagnosis of ANCA vasculitis?
Routine bloods, antibody screen, urinalysis, CXR and biopsy of an affected area
If large vessel vasculitis is left untreated- what can this lead to?
Claudicant symptoms in the limbs, reduced pulses and bruits
ENT symptoms are common in GPA. What are some examples?
Nasal crusting, epistaxis, deafness, recurrent sinusitis
What are some neurological features of small vessel vasculitis?
Mononeuritis multiplex (causing symptoms e.g. foot/wrist drop) and a glove and stocking distribution peripheral neuropathy
What are some typical features of all kinds of small vessel vasculitis?
Purpuric rash, mononeuritis multiplex, glomerulonephritis, lung opacities
Who does Henoch Schonlein purpura usually occur in? What typically precedes its occurrance?
Usually occurs in children, with a history of a recent URTI (usually GAS)
EGPA presents similarly to GPA- what are some features that characterise EGPA?
Late onset asthma, rhinitis and a peripheral blood eosinophil count of > 10%
Kawasaki disease can cause vasculitis of various vessels, but which do we worry about most?
The coronary arteries
What is an important feature of an FBC seen in ANCA vasculitis?
Anaemia of chronic disease
What investigation should be done in everyone presenting with Henoch Schonlein purpura and why?
Urinalysis, as renal involvement occurs in 50% of cases
‘Saddle nose’ is a sign associated with which type of vasculitis?
GPA
Who is Kawasaki disease usually seen in?
Children aged < 5
Why does a negative temporal artery biopsy not mean an individual does not have GCA?
There are skip lesions, so a negative biopsy does not rule out the condition
What are the two main types of large vessel vasculitis?
Giant cell arteritis and Takayasu arteritis
Henoch Schonlein purpura is a type of small vessel vasculitis mediated by what?
IgA
Cases of ANCA vasculitis with some degree of organ involvement should be managed how?
IV steroids and cyclophosphamide (stepped down to another DMAD after 3-6 months)
Who does giant cell arteritis typically affect? Which vessel is most commonly involved?
Usually involves in the temporal artery in adults aged > 50
What is the most common feature of Henoch Schonlein purpura?
Purpuric, non-blanching rash over the buttocks and lower limbs
Describe what is meant by large vessel vasculitis?
Chronic granulomatous inflammation of the aorta and its major branches
If ANCA vasculitis has no systemic involvement or constitutional symptoms, how should it be treated?
Oral steroids and methotrexate
When should treatment for GCA be started?
As soon as the condition is suspected
Which type of vasculitis is associated with hepatitis B?
Polyarteritis nodosa
Which condition is pANCA positive and associated with anti-MPO?
EGPA
What are the two main types of medium vessel vasculitis?
Kawasaki disease and polyarteritis nodosa
