Vasculitis and Fibromyalgia Flashcards
What is Takayasu’s arteritis? Where in the body does it usually occur, and whom does it usually affect?
- Large vessel granulomatous vasculitis with massive intimal fibrosis and vascular narrowing.
- Aorta
- Young females (15-30 yo)
What are some of the classic s/sx of Takayasu’s arteritis?
- Decreased to absent peripheral pulses
- B symptoms during inflammatory phase
What are the two major phases of Takayasu’s arteritis?
Inflammatory phase
Pulseless phase
What are some major sequelae of Takayasu’s arteritis?
- Renovascular HTN
- Ocular involvement
What is the characteristic type of inflammation of the vessels in Takayasu’s arteritis?
Segmental and patchy granulomatous inflammation of the aorta or its branches
What is the haplotype that is associated with Takayasu’s arteritis?
HLA-B52
What are the major criteria for Takayasu’s arteritis? (5)
- Age less than 40
- Claudication of extremities
- Decreased brachial artery pulse
- BP difference of more than 10 mmHg between arms
- Bruit over subclavian or aorta
What is the gold standard test for Takayasu’s arteritis?
Arteriogram showing occlusion or narrowing in the aorta or its main branches
Takayasu’s arteritis must occur before what age to meet its diagnostic criteria?
40
What is the BP difference between arms that is needed in the diagnostic criteria for Takayasu’s arteritis?
more than 10 mmHg between arms
What is the gold standard for diagnosing vasculitis?
Bx
Who does Kawasaki’s disease affect?
Asian children less than 4 yo
What are the s/sx of Kawasaki’s disease? (5)
- Marked Fever
- LAD /peripheral edema
- conjunctival injection
- Strawberry tongue
- Desquamating rash
What is the treatment fro Kawasaki’s disease?
ASA and IVIG
What are the s/sx of Churg-Strauss syndrome?
- Asthma
- Sinusitis
- Palpable purpura
- Peripheral neuropathy
What are the labs that are elevated with Churg-Strauss syndrome? (2)
- IgE
- MPO-ANCA (p-ANCA)
What are the s/sx of granulomatosis with polyangiitis (Wegener’s syndrome)?
- URI
- Perforation of nasal septum
- Chronic sinusitis
- OM
- Hematuria with red cell casts
What is the classic triad for granulomatosis with polyangiitis (Wegener’s syndrome)?
- Focal necrotizing vasculitis
- Necrotizing granulomas in the lung and upper airway
- Necrotizing glomerulonephritis
- Focal necrotizing vasculitis
- Necrotizing granulomas in the lung and upper airway
- Necrotizing glomerulonephritis = ?
granulomatosis with polyangiitis (Wegener’s syndrome)
What are the abs that are elevated with granulomatosis with polyangiitis (Wegener’s syndrome)?
PR3-ANCA (c-ANCA)
What is the treatment for granulomatosis with polyangiitis (Wegener’s syndrome)?
Cyclophosphamide
What are the two major vasculitides that affect large arteries?
- Giant cell (temporal) arteritis
- Takayasu arteritis
Small or small-medium vasculitis: HSP
Small
Small or small-medium vasculitis: SLE
Medium
Small or small-medium vasculitis: cryoglobulinemia
Small
Small or small-medium vasculitis: polyarteritis nodosa
Medium
Small or small-medium vasculitis: Wegener’s
Medium
Small or small-medium vasculitis: rheumatoid vasculitis
Medium
Small or small-medium vasculitis: Churg-Strauss
Medium
Small or small-medium vasculitis: microscopic polyangiitis
Medium
Small or small-medium vasculitis: Kawasaki
Medium
Small or small-medium vasculitis: vasculitis associated with malignancy
Small
Polyarteritis Nodosa is associated with what infectious disease?
Hep B
What age group Polyarteritis Nodosa classically affect?
Young adults
What are the s/sx of Polyarteritis Nodosa? (5)
- B symptoms
- HTN
- Abdominal pain / melena
- Renal damage
- Neurological disease
What vessels does Polyarteritis Nodosa classically involve?
renal and visceral vessels (not pulmonary arteries)