Vasculitis Flashcards Preview

SBM IV CT/MS > Vasculitis > Flashcards

Flashcards in Vasculitis Deck (27):

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palpable purpura


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leukocytic vasculitis


what to do if you suspect a vasculitis

1. determine extent of disease - what organs does it effect

2.  BIOPSY - or angiogram, but biopsy is better


Four types of small vessel vasculitis

  1. Henoch-Schoenlen Purpura
  2. Wegener's granulomatosis
  3. microscopic polyarteritis/polyangiitis
  4. Churg-strauss syndrome


skin clues to vasculitis

  • palpable purpura
  • ulcers - esp in stellate shape
  • nodules
  • ischemic digits
  • livido reticularis, or reticulated purpura


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reticulated purpura: a clue to deep vascular involvement


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leukocytoplastic vasculitits


Henoch-Schoenlein Purpura - sx

small vessel vasculitis w/

  1. dependent skin rash - palpable purpura
  2. abdominal pain/bloody diarrhea due to vasculitis of bowel lining
  3. glomerulonephritis - sometimes
  4. arthralgias

+ fever and malaise

in a child

usually self-limited


biopsy findings for Henoch-Scholein purpura

neutrophilic, leukocytoclastic process w/ IgA


Wegner's granulomatosis/ Granulomatosis polyangiitis

small vessel vasculitis

classic traid: granulomatous inflammation of upper airway, lower airway (lung + trachea), and kidney (focal segmental glomerulonephritis)

systemic sx: epistaxis, SOB, evidence of GN

assoc w/ cANCA in 90% (antibodies to serine proteinase 3)


Microscopic polyarteritis/polyangiitis

small vessel vasculitis

Wegner's-like presentation: involves skin, kidney, lungs (diffuse alveolar hemorrhage syndrome)

pANCA (specificity for MPO)



Churg-Strauss syndrome

small vessel vasculitis 

similar to Wegener's in pt w/ hx of asthma or atrophy

sx: pulmonary infiltrates, cardiac and neuro features w/ blood eosinophilia


polyarteritis nodosa

medium vessel vasculitis - neutrophilic

almost always secondary to Hep B

sx: ANEURYSMS, gut ischemia, renal artery involvement + hypertension, large ulcers, mononeuritis, systemic sx (weight loss, fever)




Kawasaki's disease

medium vessel vasculitis

febrile illness in children under age 6

sx: inflammation of oral mucous membrane, lymphadenopahty, rash, irritability

complication: coronary arteritis -- want to prevent this


Takayasu's aortitis

large vessel vasculutis

inflammation of aorta and its branches

initial phase: fever, malaise, weight loss, ischemic sx

later: progressive vascular occlusion, lose pulses

epi: more common in asian women


giant cell arteritis 

large vessel vasculitis

most common vasculitis in adults > 55

affects extravranial elastic arteries --> headache, facial pain, visual loss from ischemic optic neuropathy

also can present w/ polymyalgia rheumatica or wasting systemic febrile disease



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biopsy in polyarteritis nodosa - shows inflammed vessel and aneurysm

elastic lamina destroyed


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polyarteritis nodosa


common causes of secondary vasculitis

  • other connective tissue disease
  • infections: hep B and C, parvovirus, herpes zoster, SBE
  • drug induced: cocaine
  • malignancy
  • cardiac myxoma
  • cryoglobulins


eye inflammation, sinusitis, lung lesions, hemoproteinuria, gangrene of fingers

dx? lab tests?

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dx: Wegner's/ Granulomatois Polyangiitis 

test: cANCA


ANCA tests

pattern: cycoplasmic vs. perinuclear

most common antigens: cANCA = serine proteinase 3; pANCA = myeloperoxidase (MPO)


ANCA with discordanent antibodies (ex. cANCA w/ MPO)

happens w/ cocaine!


difference b/t vasculitis and vasculopathy

vascultitis: INFLAMMATION of vessel wall

vasculopathy: processes that cause vessel obstruction or narrowing that is non-inflammatory

  • examples: cholesterol emboli, amyloid, vasospasn, SBE, more....


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calciphylaxis - one cause of vasculopathy


Bechet's vasculitis

involves veins and arteries

sx: painful oral and genital ulcers, thrombophlebitis, retinal vasculitis, anterior eye disease, encephalitis, rash



Cryoglobulinemic vasculitis

cold precipitating antibodies --> small vessel vasculitis

includes GN

assoc w/ Hep C


Buerger's disease

thromboangiitis obliterans

destructive arterial and venous disease of hand and feet --> digit loss 

may be a vasculopathy rather than vasculitis

strong association w/ smoking