Vasculitis Flashcards
(36 cards)
Two types of symptoms with vasculitis?
- Non-specific systemic symptoms
* Symptoms of organ ischemia
Large vessel vasculitis involves what
Aorta and major branches
Two main types of large vessel vasculitis
Temporal (giant cell) arteritis
Most common vasculitis in adults?
Temporal arteritis
Temporal arteritis most commonly affects what?
Branches off the carotid artery
Symptoms of temporal arteritis?
- HA
- Visual disturbances
- Jaw claudication
Common lab finding in ESR
Very high ESR > 100
What are two ways that you can get ischemia secondary to vasculitis?
- Disrupt the endothelium → coagulation → thrombus
2. Injure wall → heal wall → fibrosis and narrowing
What will biopsy of temporal cell arteritis show?
Granulomatous inflammation (which shows giant cells) and intimal fibrosis (healing response)
What is the distribution of inflammation in giant cell arteritis?
It is segmental
How does Takayasu’s compare to giant cell arteritis?
Its almost the same except:
• Adults < 50 y/o (young Asian female)
• More proximal (aortic arch at branch points)
• Weak or absent pulses in upper extremity
• (will have elevated ESR and treat with steroids)
What arteries are involved in medium vessel vasculitis?
Muscular arteries supplying organs
What is polyarteritis nodosa?
A NECROTIZING vasculitis that involved MOST organs but spares the LUNGS
Symptoms of polyarteritis nodosa?
- HTN (renal arteries)
- Abdominal pain with melena (mesenteric artery)
- Neurological distrubances
- Skin lesions
- Associated with serum HBsAG
What type of necrosis is involved with polyarteritis nodosa?
Transmural fibrinoid necrosis
What is the common radiological finding in polyarteritis nodosa?
String of pearls appearance due to alternating segments of early fibrinoid necrosis and areas of fibrosis
What disease commonly affects Asian children less than 4 years of age?
Kawasakis
What are early symptoms of Kawasaki’s disease?
Vague symptoms: • Fever • Conjunctivitis • Erythematous rash on palms and soles • Enlarged cervical lymph nodes
What artery is preferentially involved with Kawasaki’s?
Coronary artery (can lead to MI or aneurysm
What is Buerger disease?
Medium vasculitis involving the arteries of the hands which will present with ulceration, gangrene, and autoamputation of the hands.
What is the treatment for Buerger disease
Stop smoking
What is Wegener’s granulomatosis?
Necrotizing granulomatous vasculitis of the nasopharynx, lungs, and kidneys
Treatment for Wegeners
Cyclophosphamide
High risk population for Wegeners
Middle aged male
