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41 Cards in this Set
- Front
- Back
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Generally, what are characteristics of vasculitis?
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inflammation and necrosis of blood vessels with resulting ischemia
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What are examples of large vessel vasculitis?
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• Giant cell arteritis/polymyalgia rheumatica
• Takayasu arteritis |
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List examples of medium vessel vasculitis
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• Churg-Strauss syndrome
• Kawaski disease • polyarteritis nodosa |
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List examples of small vessel vasculitis
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• microscopic polyarthritis
• Henoch-Schönleöin purpura • Leukocytoclastic vasculitis • Wegener's granulomatosis |
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What is the most common type of systemic vasculitis?
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Giant cell arteritis (aka temporal arteritis)
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What are clinical findings of giant cell arteritis?
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• arthralgias
• headaches • jaw claudication • malaise • scalp tenderness • visual disturbance |
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What are characteristics of polymyalgia rheumatic?
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a complex of symptoms that includes pain and stiffness of the shoulder and hip girdles and proximal extremities
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What is the treatment for giant cell arteritis/polymyaglia rheumatic?
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glucocorticoids (high dose for GCA; low dose for PMR)
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Takayasu arteritis is a large vessel vasculitis that predominantly affects young women (but can be seen in either men or women up to age 50). What vessels are affected in Takayasu arteritis?
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aorta and its main branches
• brachiocephalic • cerebral • coronary arteries • femoral • mesenteric • renal |
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What vessels are most commonly stenosed in Takayasu arteritis?
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proximal aorta and its branches
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What are treatment options for Takayasu arteritis?
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• glucocorticoids
• immunosuppressive agents (ex. methotrexate, cyclophosphamide) |
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What are characteristics of classic polyarteritis nodosa?
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• involves only medium-sized vessels
• associated with a renin-mediated HTN but spares the lungs |
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Polyarteritis nodosa is associated with which viral infections?
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Hepatitis B and C
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What are typical skin findings for polyarteritis nodosa?
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• livedo reticularis
• subcutaneous nodules • skin ulcers * reflects the involvement of deeper, medium-sized blood vessels |
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What is the most common cutaneous presentation of polyarteritis nodosa?
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lower extremity ulcerations (usually near the malleoli)
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What organ systems are most commonly affected by polyarteritis nodosa?
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• renal
• gastrointestinal • peripheral nervous system |
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What are lab findings of polyarteritis nodosa?
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• anemia
• leukocytosis • elevated ESR * usualy ANCA-negative |
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What is the treatment for polyarteritis nodosa?
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• glucocorticoids
• immunosuppressives (used in severe cases) |
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What is another name for Churg-Strauss Syndrome?
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• allergic granulomatosis
• angiitis |
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What is the classic presentation of Churg-Strauss syndrome?
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middle aged women with chronic asthma who develops pulmonary infiltrates, vasculitis, and eosinophilia
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What are significant lab findings in patients with Churg-Strauss Syndrome?
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• eosinophilia
• antineutrophil cytoplasmic autoantibodies (ANCA): usually P-ANCA |
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Wegener's granulomatosis is a small to medium vessel vasculitis with many extravascular maniffestations. What are the most common sites of involvement?
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• sinus and upper airway
• lung • kidney |
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What are upper respiratory tract symptoms seen in Wegener's granulmatosis?
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• inflammation of the gums
• mastoiditis • nasal congestion • otitis media • sinusitis • stridor |
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What are examples of ocular manifestations of Wegener's granulomatosis?
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• anterior uveitis
• episcleritis • keratitis • proptosis • scleritis |
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Henoch-Schonlein purpura is small vessel vasculitis most common affecting what patients?
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children and young adults
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What is the classic clinical triad of Henoch-Schonlein purpura?
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• abdominal pain
• arthritis • palpable purpura |
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IgA deposition in glomerular lesions is characteristics of what vasculitis condition?
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Henoch-Schonlein Purpura
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What is Leukocytoclastic vasculitis?
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• refers to inflammation and fibrinoid necrosis of vessel walls
• deposition of cellular debris in the surrounding tissue of the skin • more of a sign of disaese rather than a unique vasculitis |
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What is the clinical sign of Leukocytoclastic vasculitis?
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palpable purpura
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When LCV is an isolated finding, what is a common cause?
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drug reaction
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What is the "gold standard" test for diagnosing vasculitis?
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tissue biopsy
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Angiography can be used to diagnose vasculitis. What are some abnormalities that can be seen on angiography?
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• microaneurysms
• stenosis • tapering |
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What vasculitis disorders are associated with positive ANCA?
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• Churg-Strauss syndrome
• microscopic polyangitis • Wegener's granulomatosis |
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What are characteristics of antiphospholipid syndrome?
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• destructive thrombocytopenia
• recurrent thrombosis • fetal loss |
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How is antiphospholipid syndrome diagnosed?
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by demonstration of a lupus anticoagulant and/or anticardiolipin antibody
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What is Livido reticularis?
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• a mottled purplish discoloration of the skin
• "fish-net" appears • a cutaneous manifestation of vasculitis |
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What are extrapulmonary manifestations of sarcoidosis?
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• joint-related pain
• sialoadentitis • skin lesions |
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What is a cytotoxic response?
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• aka serum sickness
• fever, lymphadenopathy, myalgias (B symptoms) |
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What infectious disease can produce a vasculitis?
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tertiary syphilis (meningovasular etiology that can present like a stroke)
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What are clincial manifestations of Kawaski disease?
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• fever
• cervical lymphadenopathy • conjunctivitis • mucous membrane changes (ex. injected pharynx, erythema, swelling & fissuring of lips, strawberry tongue) • peripheral extremity changes (ex. edema, desquamation, erythema of palms or soles, induration of hands & feet) • rash |
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What is a major complication of Kawaski disease?
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arteritis of the coronary vessels
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