Medium/Small vessel vasculitises Flashcards
What is Wegeners granulomatosis (Granulomatous polyangitis) and who does it tend to affect?
North European middle aged men aged 35-55 (still rare) and it is a destructive vasculitis.
What are the antibodies made against for Wegeners?
Anti neutriphil cytoplasmic antibodies -
Body attacks neutrophils and this activates them and causes adherence to vessel walls.
What are the common symptoms of Wegners?
REMEMBER ALL VASCULITIS SYMPTOMS
ENT - sinusitis, saddle nose deformity, otitis media
Lung - Granulomas, cough, haemoptysis
Renal - kidney failure
MIDLINE SYMPTOMS
What is this?
Saddle nose deformity
What is this?
Granulomas in lung from Wegners
What is the key blood test for Wegners?
Raised cANCA and PR3
Raised neutrophils
What other bloods are raised in Wegners?
CRP/ESR
Normocytic anaemia
What is the treatment of (Granulomatous polyangitis)?
Steroids and immunosuppresants to get under control and keep in remission
What is Polyarteritis Nodosa (PAN)?
Similar to Wegners but it doesnt cause granulomas and it affects nerves more
It is associated with testicular pain and Hep B
What is Microscopic Polyangitis (MPA)?
It is similar to Wegners and polyarteritis nodosa (PAN) but is associated with p-ANCA
What is Churg Strauss Syndrome?
This is similar to Wegners, polyarteritis nodosa and Microscopic polyangitis, but
associated with adult onset asthma and eosonophilia
adult onset asthma + vasculitis = churg Strauss
Bloods show raised eosinophils plus raised ANCA
What is the treatment for the medium/small vessel vasculitises?
Steroids, immunosuppresants, Anti TNF
Then maintain remission with things like methotrexate, azathioprine
What is antiphospholipid syndrome?
Antibodies against fat (antiphospholipids) causing thromobosis and :
- MI
- stroke
- recurrent miscarriages
- DVT
- migraines
- organ failure
Treat with warfarin
