Vasculitis Flashcards
define vasculitis
this is inflammation of the blood vessels
what is vasculitis associated with
ischaemia
necrosis
organ inflammation
define primary vasculitis
results from inflammatory response that targets the vessel walls
define secondary vasculitis
triggered by infection, drug, toxin or predisposing condition
presentation of vasculitis
systemic= fever, malaise, weight loss
bruit, claudication and high BP
organ involvement, especially kidneys as asymptomatic
diagnosis of vasculitis
- urinalysis for kidneys/glomerular nephritis
- ESR/plasma viscosity/ CRP/ complement reduced (C3/4 immune complex forming)
- temporal artery biopsy or any affected area to detect granulomas
- immunofluorescence for ANCA
- antibodies (anti-PR3- GPA and anto-mpo- EGPA)
- CXR (granulomas with a caveatting centre)
CT of abdomen
management of vasculitis
prednisolone (high dose steroids)
immunosuppressants e.g. cyclophosphamide (FIRST LINE) methotrexate, azathioprine, rituximab
two types of large vessels vasculitis
takayasu arteritis (TA) giant cell arteritis (GCA)
define takayasu arteritis
inflammation of all the large vessels, seen in developing parts of the world
presentation of giant cell arteritis
loss of sight/vision change
tenderness of scalp
prominent temporal arteries and loss of pulse due to thickened wall
diagnosis of giant cell arteritis
biopsy
management of giant cell arteritis
steroids
what is small vessels vasculitis divided into?
ANCA positive and negative
four examples of small vessel vasculitis
- granulomatosis with polyangiitis (GPA)
- eosinophilic granulomatosis with polyangiitis (EGPA)
- microscopic polyangiitis
- HSP
define granulomatosis with polyangiitis
inflammation of the respiratory tract
presentation of granulomatosis with polyangiitis
mouth ulcers
hearing loss
systemically unwell- purpuric non-blanching rash and palsy symptoms
define eosinophilic granulomatosis with polyangiitis (EGPA)
eosinophilic granulomatous inflammation of respiratory tract with late onset asthma and high eosinophils. they patients are systemically well
define microscopic polyangiitis
necrotising vasculitis with few deposits
define Henoch-Schoenlein Purpura (HSP)
acute IgA mediated disorder
what ages does HSP present in?
2- 11 years
what is common in HSP
preceding infection
presentation of HSP
purpuric rash over lower limbs
abdominal pain
diarrhoea
joint swellings
management of HSP
usually resolves within 8 weeks
what test should be done in HSP
urinalysis for renal involvement
which vasculitis is associated with p-ANCA and anti-MPO
MPA
which vasculitis is associated with c-ANCA and anti-PR3
GPA
