Vasculitis

Question 1

What is vasculitis?

How is it categorised?

Answer 1

Vessel inflammation leading to vessel damage, and in turn bleeding, stenosis and ischaemia.

The size of the vessel

Question 2

Large vasculitis:

What 2 diseases cause this? - G, T

They are generally very dangerous due to the risk of impaired blood flow in such large vessels.

Answer 2

Giant cell arteritis

Takayasu’s arteritis

Question 3

Medium vasculitis:

What 2 diseases cause this? - PN, KD

Answer 3

Polyarteritis Nodusa (PAN)
Kawasaki's Disease

Question 4

Small vasculitis:

Read card

Answer 4

Causes:

Immune complex related vasculitis

ANCA-associated vasculitis

Anti-GBM disease

Cyroglobinaemic vasculitis

IgA vasculitis (Henoch-Schonien Purpura)

YOU CAN READ MORE IN BOOK BUT THEY AREN’T NECESSARY TO KNOW!

Question 5

Vasculitic Purpura:

How can you differentiate coagulopathic purpura from vasculitic purpura from how it feels?

How does VP tend to be distributed compared to CP?

How does the VP progress? - CP doesn’t progress

Answer 5

VP - raised and palpable
CP - flat

VP - localised - especially in shins
CP - a widespread rash

Often blister, necrose and ulcerate, while retaining an actively-inflamed, purple/red edge

Question 6

Features of vasculitis:

Systemic symptoms - 5

Skin:

• What swells in livedo reticularis?
• What triggers it?
• What forms in the nailbeds?
• What do vasculitic ulcers look like?

Eyes:
- What becomes inflamed in the eye due to vasculitis?

Pulmonary:
- They get pulmonary haemorrhage. What sort of symptoms will they have?

Answer 6

Fever
Malaise - there is overwhelming fatigue 
Weight loss 
Arthralgia 
Myalgia 

Swelling of medium vessels due to cold or physiological processes

Nailbed infarcts

Blue-purple edge

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Episcleritis
Scleritis

Haemoptysis and SOB

Question 7

Features of vasculitis:

Cardiac:
- What does coronary arteritis cause?

GI:
- Why could they get malabsorption?

It also has renal, neurological and GU effects!!!

Answer 7

MI and Angina

Chronic ischaemia