Medium vessel vasculitis

Question 1

Polyarteritis nodosa:

characteristic

Answer 1

Young adults
HepB seropositive in 30%

Constitutional +
GI (abd pain, melena)
HTN, 
neurologic, 
cutaneous eruption, 
renal damage

Question 2

Polyarteritis nodosa:

pathology

Answer 2

Typically involves renal and visceral vessels, NOT pulm arteries.
Immune complex mediated
Transmural inflam of the arterial wall with fibrinoid necrosis.
Lesions are of different ages.
Many aneurysms and constrictions on arteriogram

Treat with corticosteroid, cyclophosphamide.

Question 3

Kawasaki disease:

characteristic

Answer 3

Asian children

Hand-foot erythema
“Strawberry tongue”
Conjuctivial injection
desquamating rash

Question 4

Kawasaki disease:

pathology

Answer 4

May develop coronary aneurysm -> MI, rupture

Treat with IVIG and aspirin.

Question 5

Buerger’s disease (thromboangiitis obliterans):

characteristic

Answer 5

Heavy smoker, male < 40 years of age
Intermittent claudication may lead to gangrene,
autoamputation of digits, 
superficial nodular phlebitis
Raynaud often present

Question 6

Buerger’s disease (thromboangiitis obliterans):

pathology

Answer 6

segmental thrombosing vasculitis

Treat with smoking cessation.