vasculitis from FA Flashcards
temporal arteritis presentation
old lady
headache on one side
jaw pain(claudication)
blindness(opthalmic occlusion)
polymyalgia rheumatic assn. – pain or stiffness, usually in the neck, shoulders, upper arms and hips
pathophysiology of temporal arteritis
focal granulomatous inflammation
affects branches of carotid artery
treatment for temporal arteritis
corticosteroids
takayasu arteritis presentation
young asian female(<40)
weak upper extremity pulses
visual/neuro disturbances – lack of blood flow
arms have different pressures(by at least 10 mmHg)
constitutional symptoms: fever, night sweats, arthritis, myalgias, skin nodules, ocular disturbances
takayasu pathophysiology
granulomatous thickening/narrowing of aortic arch and its branches
increased ESR due to inflammation
treatment for takayasu arteritis
corticosteroids
polyarteritis nodosa presentation
young adult
w/fevere, wt loss, malaise, HA,
abdominal pain and melena(black stool)
HTN
neuro dysfunction
skin lesions
renal damage
HBV+ in 30%
pathophysiology for polyarteritis nodosa
medium/small vessel vasculitis
immune complex mediated
transmural inflammation of arterial wall
w/ fibrinoid necrosis inolving
multiple organs(lungs spared)
treatment for polyarteritis nodosa
corticosteroids and cyclophosphamdie
kawasaki disease presentation
young asian child
mucocutaneous lymph node syndrome: red eyes, red feet, red hands, red tongue, adenopathy, fever
pathophysiology of kawasaki disease
medium vessel vasculitis
autoimmune mediated vasculitis
commonly affects coronary vessels
can cause aneurysms, thrombosis, rupture leading to death
treatment for kawasaki disease
IVIG
aspirin
buerger disease presentation
young smoking male
autoamputation of fingers
ulceration/gangrene of fingers/toes
raynaud phenomenon
pathophysiology of buerger’s disease
segmental thrombosing/necrotizing vasculitis
involves digits!
treatment of buerger’s disease
STOP SMOKING DUMMY
causes of medium-vessel vasculitis
polyarteritis nodosa
kawasaki disease
buerger disease
presentation of wegener’s disease
upper respiratory problems: sinusitis, otitis media, saddle nose
lower respiratory problems: hemoptysis, cough, dyspnea
kidney problems: - RPGN! – hematuria, red cell casts
pathophysiology of wegener’s disease
Triad:
focal necrotizing vasculitis
necrotizing granulomas of lung and upper airway
necrotizing glomerulonephritis
C-ANCA(PR3) mediated
treatment for wegener’s disease
cyclophosphamide and corticosteroids
microscopic polyangiitis presentation
lung and kidney problems; no nasopharynx(wegener)
palpable purpura
differentiated from wegeners pathologically
pathophysiology of microscopic polyangiitis
small vessel necrotizing vasculitis
no granulomas
P-ANCA(MPO) present
treatment for microscopic polyangiitis
corticosteroids and cyclophosphamide
churg-strauss presentation
small vessel vasculitis presenting with:
asthma, sinusitis
skin nodules, purpura
peripheral neuropathy(writs, foot drop)
heart, GI, kidney involvement
churg strauss pathophysiology
granulomatous, necrotizing vasculitis with eosinophilia
p-ANCA
henoch-schonlein purpura presentation
most common childhood systemic vasculitis
kid with:
palpable purpura on leg and butt
arthralgia
abdominal pain
henoch-schonlein purpura pathophysiology
vasculitis secondary to IgA immune complex deposition
associated with IgA nephrophaty(berger disease)
