Vasculitis Syndromes Flashcards
what are the 3 vasculitis syndromes we are learning about
Polyarteritis nodosa (PAN)
Giant cell arteritis/Temporal Arteritis
Takaysu’s Arteritis
what happens in a vasculitis
inflammation and damage to the BVs
the vessel lumen is usually compromised and this is associated with ischemia of the tissues supplied by the involved vessel
how is vasculitis syndrome classified
as affecting the small, med, or lg vessels
what is the accepted theory?
the deposition of immune complexes in the vessel walls results in compromise of the vessel lumen with ischemic changes in the tissues supplied by the involved vessels
what size vessels does PAN affect
small and medium
involvement with which arteries is common in PAN
renal arteries
visceral arteries
***characteristic
what two diseases can PAN be associated with
hairy cell leukemia
significant HTN
where do the lesions usually affect the arteries in PAN
at the bifurcation and branching of the arteries
which type of cell infiltrates the vessel wall and perivascular areas, resulting in intimal proliferation and degeneration of the vessel wall (PAN)
polymorphonuclear neutrophils
what comes along with necrosis of the vessel (PAN)
compromise of the lumen, thrombosis, or infarction of the tissue
as the lesions heal, that is deposited in the vessel which may cause further occlusion of the lumen? PAN
collagen deposition
what sort of dilations are characteristic of PAN
aneurysmal dilations
what nonspecific signs and symptoms may someone with PAN present with
fever, weight loss, malaise, weakness, h/a, abdominal pain, myalgias
what involvement is MC with PAN
RENAL involvement. . manifests as HTN, hemorrhage (in the form of microanurysms), or renal insufficiency
organ systems involved with PAN (from most to least common)
renal - htn, failure MS - arthritis, arthralgia, myalgia PNS GI Skin (raynauds too) Cardiac GU CNS
what are the diagnostic serologic tests for PAN
there are none
what labs should you get for PAN
normochromic normocytic anemia
cbc - increased leukocyte count with neutophil predom
elevated ESR
other labs that have to do with the organ involvef
how do you get the diagnosis for PAN
biopsy of involved organ (provides highest diagnostic yield)
arteriographic demonstration of involved vessels (aneurysms, stenotic segments of involved vessels)
what is the treatment for PAN
prednisone and cyclophosphamide
what does death usually result from in a person with PAN
bowel infarct, bowel perf, CV causes
what size arteries does giant cell arteritis affect?
medium and large
WHICH arteries are characteristically involved in giant cell arteritis
one or more branch of the carotid artery (particularly temporal)
also the aorta and its branches
what disease is giant cell closely associated with
polymyalgia rheumatica
what are the clinical manifestations of polymyalgia rheumatica
stiffness, aching, pain in the muscles of the neck, shoulders, lower back, hips, and thighs
increased ESR