Vasculitis Biopsy Findings

Question 1

giant cell arteritis - biopsy findings

Answer 1

*biopsy of the temporal artery shows:
-granulomatous inflammation
-multi-nucleated giant cells
-predominantly involves media and elastic lamina fragmentation

Question 2

giant cell arteritis - first steps in management

Answer 2

*start high dose steroids PRIOR to biopsy if suspected

Question 3

polymyalgia rheumatica - symptoms

Answer 3

*pain and stiffness in symmetric proximal muscles (shoulder and hip girdle muscles)
*ABSENCE OF TRUE WEAKNESS

recall: associated with GCA

Question 4

Takayasu’s arteritis - diagnosis & biopsy findings

Answer 4

*dx = angiography (conventional, CTA, MRA)
*biopsy not generally feasible but would show granulomatous inflammation

Question 5

polyarteritis nodosa (PAN) - biopsy findings

Answer 5

*biopsy of skin, muscle, or sural nerve shows:
-transmural inflammation
-fibrinoid necrosis

Question 6

polyarteritis nodosa (PAN) - symptoms

Answer 6

*fever, arthralgia, weight loss
*peripheral nerve involvement
*renal involvement (HTN)
*testicular pain
*palpable purpura
*micro-aneurismal formation

recall: often associated with Hep B

Question 7

GPA - biopsy findings

Answer 7

*lung biopsy = granulomas in tissue
*kidney biopsy = pauci-immune glomerulonephritis

Question 8

microscopic polyangiitis (MPA) - biopsy findings

Answer 8

*biopsy of skin, lung, or kidney shows:
-necrotizing, but NOT granulomatous

Question 9

EGPA - biopsy findings

Answer 9

*biopsy shows:
-granulomatous, necrotizing vasculitis
-eosinophilic tissue infiltration