Vasculitis investigation and treatment Flashcards
what is the initial treatment of large cell vasculitis
prednisolone, higher dose if eye involvement
but still low doses
what steroid sparing agents can be considered in large cell vasculitis
leflunamide or methotrexate
if steroids are not working in large cell vasculitis what treatment may be used
tocilizumab(IL-6 inhibitor)
what imaging investigations can be used for vasculitis
CXR, CT scan, angiogram
what is the gold standard investigation of vasculitis
tissue biopsy
what other investigations are done for vasculitis
FBC, inflammatory markers, compliment levels, ANCA antibody
what investigation is used to identify ANCA
immunofluorescence in cytoplasm of neutrophil
what C3 and C4 levels may be seen in vasculitis
reduced C3 and C4 as they are used up in complement system
what does the management of ANCA-associated vasculitis depend on
degree of involvement, are organs involved, is it life-threatening etc
what treatment is given in localised/early systemic ANCA-associated vasculitis
initial steroid(prednisolone) dose and continued methotrexate
what can be used as a methotrexate alternative
azathioprine
what is the first line treatment of generalised/systemic ANCA-associated vasculitis
cyclophosphamide + high dose steroids
what can be used as a cyclophosphamide alternative
rituximab
what is involved in the maintenance treatment of generalised/systemic ANCA-associated vasculitis
azathioprine
alternatives = methotrexate, mycophenolate, leflunomide
what is involved in the treatment of refractory ANCA-associated vasculitis
IV immunoglobins and rituximab
