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5 classifications of vasculitides
- Large vessel: granulomatous
- Medium vessel: anti-endothelial or immune complex
- Small vessel: ANCA or immune complex
- Infectious
- Other
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2 large vessel vasculitides
- Giant cell (temporal) vasculitis: most common adult vasculitis, F>M; cell-mediated immune rxn; granulomas
- Takayasu arteritis: <40yoa, F>M; narrowing of carotid, subclavian (pulseless); granulomatous, intimal fibrosis
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2 medium vessel vasculitides
- Polyarteritis nodosa: segmental transmural necrotizing; 30% with HepB antibodies; young adults; renal failure, 2* hypertension
- Kawasaki disease: transmural necrotizing; coronary artery involvement; 2* to viral/bacterial infection; <5yoa; rash and strawberry tongue
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3 small vessel vasculitides
- Microscopic polyangiitis: p-ANCA (MPO); 50yoa; no granulomas, asthma; segmental necrotizing; hypersensitivity (rash)
- Churg-Strauss syndrome: p-ANCA (MPO); 50yoa; bronchial asthma; necrotizing granulomas with eosinophils
- Wegener granulomatosis: c-ANCA (PR3); adult; necrotizing granulomas in upper airway/lungs, kidneys
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3 "other" vasculitides
- Thromboangiitis obliterans: aka Buerger; smokers; gangrene extremeties; stop smoking
- Henoch-Schonlein purpura: most common child vasculitis; IgA and complement immune deposits; follows infection (viral, strepA); self-limited
- Raynaud disease: cold-induced vasospasm, part of CREST
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