Flashcards in Vasculitis and Complications of MIs Deck (55)
Two divisions of vasulitis
Infectious and non-infectious (primary)
Predominant fungal cause of infectious vasculitls
Predominant bacterial cause of IV
Predominant bacterial cause
Pathophysiology of Primary Vasculitis
Dendritic cells int eh tunica adventitia go haywire and instead of disposing of self-recognizing immune cells they activate them. These immune cells then degrade the elastic lamina
Another mechanism.... Immune complex deposition. Inflammation mediated by complement, chemoattractants, neutrophils, lysosomal enzymes, free radicals.
Major signs and symptoms
palpable purpura and fever
acute necrotizing inflammatory disease of the smallest vessels (arterioles, cappilaries, venuoles). Usually in the skin
Cutaneous hypersensitivity angiitis also referred to as?
10% of cases of hypersensitivity angiitis due to?
Quinolones, penicillins, sulfonamides, Retinoids, etc...
Microscopic polyangiitis is
hypersensitivity angiitis involving internal organs
Pathogenesis of hypersensitivity angiitis?
immune complex deposition and complement activation 7-10 days after exposure to an antigen (drug)
Pathology of hypersensitivity angiitis
infiltration of vessels by neutrophils, later lymphocytes
stop the drug, treat the infection, excise the tumor...etc...
If it infects the organs, treat with immunosuppresive therapy
Giant cell arteritis, granulomatous inflammatory disease of medium and larger arteries, esp in the head
Temporal arteritis common
Fairly...1 in 750 over the age of 50, female predominance, more common in whites
Temporal arteritis autoimmune?
Pathology of temporal arteritis
multinucleated giant cells destroy internal elastic lamina. Transmural granulomatous inflammation. Intimal thickening, cell proliferation and luminal stenosis
Signs and symptoms
headache, visual disturbance, jaw claudication, swollen tender artery.
Fever malaise and wt loss make blindness less likely
chronic autoimmune inflammatory disease of muscle. Temporal arteritis is associated with it in 40% of cases.
Complcations of temporal arteritis
blindness, aortic aneurysm, arterial dissection, arterial rupture
Temporal arteritis is diagnosed by
ESR and biopsy
Treat temporal arteritis with
old white women
mucocutaneous lymph node syndrome...vasculitis of medium arteries, especially coronaries.
kawasaki predominantly effects who>
children 1-2 yrs of age, males, japanese
arterial rupture, MI, death