Flashcards in Vasculitis Deck (25):
Treatment of PMR or GCA
-If these don't work then question your diagnosis
-PMR (prednisolone 10-15mg)
-GCA (prednisolone 60-100mg usually in divided doses)
Calcium and Vitamin D supplements are necessary to prevent osteoporosis while high dose steroids are being used
PMR and GCA differential diagnoses
RA, vasculitis, infection, malignancy
Increased frequency of what allele in spondyloarthritis?
Giant Cell Arteritis
Isolated CNS vasculitis
Vasculitis 2nd to CTD
Vasculitis 2nd to viral infection
Microscopic Poly angiitis (70%)
Definition of vasculitis
Presence of leukocytes/immune complexes in the vessel wall with reactive damage to mural structures
Anti-PR3 antibodies are highly specific for which condition?
Used to help investigate possible vasculitis
If cANCA is associated with MPO but not PR3 then consider different diagnosis such as non-ANCA associated vasculitis e.g. drug induced
If cANCA positive but doesn't demonstrate PR3 pattern then it is most likely due to the presence of bacterial permeability increasing protein ANCA found in chronic infections e.g. CF, bronchiectasis, subacute bacterial endocarditis, ulcerative colitis
Which medications will cause a large titre of MPO antibodies?
Hydralazine, allopurinol and propylthiouracil can cause a large titre of MPO antibodies
Give an example of a pauci-immune vasculitis
Wegeners (pauci-immune = neutrophils found in vessels)
Give an example of a primary immune vaculitis
How do you assess vasculitis?
(Birmingham vasculitis assessment score)
BVAS (Birmingham vasculitis assessment score)
Used to assess vasculitis
Nuetrophils in blood vessel
Immune complexes in blood vessel
Treatment for localised/early systemic vasculitis
Methotrexate and steroids
First line and alternative treatment for general/systemic vasculitis?
1st line = cyclophosphamide + steroids
Alternative = Rituximab and steroids
Treatment for refractory vasculitis?
Causes of death in people with vasculitis?
Infection, cardiovascular disease and cancer