Vasculitis | Anatomy2Medicine
Vasculitis Causes

Vasculitis

 

  • Vasculitis syndromes (vasculitides)
  • Polyarteritis nodosa
        • characterized by necrotizing immune complex inflammation of small- and medium-sized arteries.(MCQ)
  • it is marked by the destruction of arterial media and internal elastic lamella (MCQ)
  • result in aneurysmal nodules. (MCQ)
        • Has association with hepatitis B viral infection in 30% of patients. (MCQ)
        • Clinical manifestations often include
          • fever, weight loss, malaise
          • abdominal pain, headache(MCQ)
          • myalgia, and hypertension (MCQ)
        • Polyarteritis nodosa is seen in the following sites:
  • Kidneys
  • immune complex vasculitis in the arterioles and glomeruli(MCQ)
            • renal lesions and hypertension cause most deaths from polyarteritis nodosa. (MCQ)
  • Coronary arteries, resulting in ischemic heart disease (MCQ)
  • Musculoskeletal system, resulting in myalgia, arthralgia, or arthritis(MCQ)
  • Gastrointestinal tract, manifesting as nausea, vomiting, or abdominal pain
  • Central nervous system (CNS)
          • peripheral nervous system, the eye, or skin
  • Churg-Strauss syndrome (allergic granulomatous angiitis).
        • necrotizing vasculitis
        • characterized by
          • prominent involvement of the pulmonary vasculature(MCQ)
          • marked peripheral eosinophilia(MCQ)
          • clinical manifestations of asthma. (MCQ)
  • Hypersensitivity (leukocytoclastic) vasculitis
  • a group of immune complex-mediated vasculitides
  • characterized by acute inflammation of small blood vessels (arterioles, capillaries, venules) (MCQ)
  • the multiple lesions tend to be of the same age. in contrast to the findings in polyarteritis nodosa. (MCQ)
        • It  manifests by palpable purpura when the skin is involved
  • It can involve glomeruli or the gastrointestinal tract.
        • It may be precipitated by exogenous antigens, such as drugs, foods, or infectious organisms
        • It may also occur as a complication of systemic illnesses, such as connective tissue disorders or malignancies.
        • It presents clinically in distinctive syndromes, including:
  • Henoch-Schönlein purpura
          • Serum sickness
        • Henoch-Schönlein purpura
          • most common in young children.
  • Characteristics include

hemorrhagic urticaria of extensor surfaces of the arms, legs, and buttocks, fever, arthralgias

            • gastrointestinal involvement(MCQ)
            • renal involvement (often similar to IgA nephropathy). (MCQ)
          • This disorder can sometimes be poststreptococcal in origin(MCQ)
          • It is associated with antecedent upper respiratory infections, suggesting that infectious agents may be the inciting antigens(MCQ)
          • other inciting antigens may include drugs or foods.
      • Wegener granulomatosis.
        • characterized by necrotizing granulomatous vasculitis of the small- to medium-sized vessels (MCQ)
  • involves respiratory tract, kidneys
        • clinical presentation
          • respiratory tract signs and symptoms, especially of the paranasal sinuses and lungs(MCQ)
          • necrotizing glomerulonephritis (sometimes with immune complex deposition). (MCQ)
  • Manifestations include
          • fibrinoid necrosis of small arteries and veins(MCQ)
  • early infiltration by neutrophils, subsequent mononuclear cell infiltration, and fibrosis. (MCQ)
          • Granuloma formation with giant cells is prominent.
  • In most cases, WG is associated with circulating antineutrophil cytoplasmic antibodies with a cytoplasmic staining pattern (C-ANCAs). (MCQ)
      • Giant cell arteritides
        • are seen in medium- to large-sized arteries
        • characterized by granuloma formation with giant cells, as well as by infiltrates of mononuclear cells, neutrophils, and eosinophils.
        • They include two distinct clinical syndromes:
  • Temporal arteritis
          • Takayasu arteritis
        • Temporal arteritis
          • most frequently occurring form of vasculitis.
  • It is systemic vasculitis
  • occurs most often in elderly persons(MCQ)
          • It usually affects branches of the carotid artery, particularly the temporal artery.
          • Clinical manifestations include:
            • Malaise and fatigue
            • Headache  (MCQ)
            • claudication of the jaw(MCQ)
  • Tenderness, absent pulse, and palpable nodules along the course of the involved artery(MCQ)
            • Visual impairment, especially with involvement of the ophthalmic artery(MCQ)
  • Polymyalgia rheumatica
  • a complex of symptoms including proximal muscle pain, periarticular pain, and morning stiffness(MCQ)
            • Markedly elevated erythrocyte sedimentation rate(MCQ)
        • Takayasu arteritis (pulseless disease) (MCQ)
          • characterized by inflammation and stenosis of medium- and large-sized arteries (MCQ)
  • shows frequent involvement of the aortic arch and its branches, producing aortic arch syndrome(MCQ)
          • Clinical manifestations include:
            • Absent pulses in carotid, radial, or ulnar arteries(MCQ)
            • Nonspecific findings like fever, night sweats, malaise, myalgia , arthritis and arthralgia
            • eye problems
            • painful skin nodules
  • Mucocutaneous lymph node syndrome (Kawasaki disease)
  • an acute, self-limited illness of infants and young children
        • characterized by acute necrotizing vasculitis (MCQ)
        • involves  small- and medium-sized vessels.
        • Clinical manifestations
  • Fever
  • hemorrhagic edema of conjunctivae, lips, and oral mucosa(MCQ)
  • cervical lymphadenopathy. (MCQ)
  • It can be a cause of coronary artery vasculitis with aneurysm formation. (MCQ)
      • Thromboangiitis obliterans (Buerger disease) (MCQ)
        • is an acute inflammation involving small- to medium-sized arteries of the extremities
        • extend to adjacent veins and nerves.
        • most common  young men.
        • result in painful ischemic disease, often leading to gangrene
  • It is clearly exacerbated by heavy cigarette smoking. (MCQ)
    • Lymphomatoid granulomatosis
      • is a rare granulomatous vasculitis
      • characterized by infiltration by atypical lymphocytoid and plasmacytoid cells.
      • progress from a chronic inflammatory condition to a T-cell non-Hodgkin lymphoma. (MCQ)