Vasculitis Lecture notes Flashcards
Activated immune cells infiltrate into vessel wall and leads to direct damage and stimulates vascular s___ m____ cell remodelling
smooth muscle
Vessel wall infiltration, proliferation and damage causes w_____ and o_____ of blood vessel
weakening and occlusion
Leads to ischaemia, i_____, aneurysm
infarction
Results in clinical manifestations which may be in an identifiable pattern consistent with a clinical syndrome
What are the 2 phases of initial treatment for vasculitis?
Induction of remission
Maintenance of remission
What is used for induction of remission in vasculitis?
Corticosteroid plus additional immunosuppression
eg IV methylprednisolone and cyclophosphamide (CYC)
What does cyclophosphamide affect?
Fertility
Can use Rituximab instead
How is remission maintained?
Aim to prevent life-threatening relapses, may be lifelong.
DMARDs
what does GCA stand for?
Giant Cell Arteritis
True or false: GCA is the most common vasculitis
True
What age is GCA mainly seen in?
70-80 y/o
Rare below 50
GCA is a medical emergency. Can cause s____ and b_____. the visual outcomes are poor.
strokes and blindness
What are symptoms of GCA?
New localised headache
Temporal pain (unilateral temple headache
Jaw and tongue claudication
Vision changes
Temporal scalp tenderness
Polymyalgia
How do you investigate GCA?
Anaemia of chronic disease
Thrombocytosis
Raised CRP and ESR
Temporal artery biopsy (gold standard)
USS
A positive temporal artery biopsy will show…
Granulomatous inflammation of media and intima
Patchy skip lesions so a big chunk needed for biopsy
