Vasculitis Flashcards
what is temporal arteritis?
a granulomatous vaculitis of large and medium sized vessels that predominantly affects the branches of the external carotid. Symptoms of PMR also commonly seen alongside
what are the S&S of GCA?
headache - typically over temporal or occipital areas
temporal artery and scalp tenderness (e.g pain when combing hair)
jaw claudication (pain on chewing)
thickening and nodularity of temporal artery and its branches
PMR symptoms
absent temporal artery pulse
what InV are done in temporal arteritis?
FBC
- normocytic normochromic anaemia
- mildly elevated WBC
- increased platelets
Increased ESR and CRP
LFTs midly elevated
Temporal artery US
- wall thickening (halo sign), stenosis or occlusion
Temporal artery biopsy
- gold standard for Dx
- granulomatous inflammation with multinucleated gaint cells
- skip lesions so can be missed
what is the treatment for GCA?
Prednisolone
Aspirin
Tocilizumab or MTX for relapsing disease
what are the complications of CGA?
vision loss
Glucorticoid side effects
aortic aneurysms
large vessel stenosis
what is polyarteritis nodosa?
a necrotising vasculitis that causes aneurysms and thrombosis in medium sized arteries leading to infarction in affected organs with severe systemic symptoms
what are the S&S of polyarteritis nodosa?
fever, weight loss and myalgia mononeuritis multiplex parasthesiae abdo pain (ischaemia of abdo organs) skin manifestations (ulcers, purpura, eruption) high diastolic BP
what InV are done in polyarteritis nodosa?
FBC
- increased WCC
- mild eosinophilia
- Anaemia
Increased ESR and CRP
ANCA -ve
renal or mesenteric angiography
how is polyarteritis nodosa treated?
BP control
Corticosteriods or cyclophosphamide
what is Henoch-Schonlein purpura ?
the most common vasculitis of childhood which affects the small vessels. It is characterised by a tetrad of
- rash
- abdo pain
- arthritis/arthralgia
- glomerulonephritis
what can trigger HSP?
URTI or streptococcal infections
what are the S&S of HSP?
arthralgia
- knees and ankles commonly
Abdo pain
- often associated with N&V
Skin rash
- palpable non-blanching purpura
- extravasation of blood into skin
- usually on lower extremities
nephritic signs
- haematuria, proteinuria, high BP
scrotal pain/swelling, headaches and seizures may manifest
what InV are done in HSP?
urinalysis
- RBCs, proteinuria or casts
24hr urinary protein
- may be elevated due to renal involvement
Serum IgA
- raised
renal biopsy
- IgA in mesangium
what is the treatment of HSP?
analgesia
corticosteroids
plasmapharesis
what is granlumomatosis with polyangiitis? (Wegener’s)
a systemic vasculitis that typically involves small and medium sized vessels. Although any organ can be affected, the classical triad consists of;
- upper respiratory tract involvement
- lower respiratory tract involvement
- pauci-immune glomerulonephritis
