Rheumatology Book

Environmental Injury

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Vasculitis

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  1. Definition
    1. Primary disorder of vascular inflammation
  2. Epidemiology
    1. Cutaneous Small Vessel Vasculitis is most common
  3. Types
    1. Large-Vessel Vasculitis
      1. Giant Cell Arteritis
      2. Takayasu's Disease
    2. Medium-Vessel Vasculitis
      1. Polyarteritis Nodosa
      2. Kawasaki's Disease
    3. Small-Vessel Vasculitis (ANCA or Non-ANCA associated)
      1. Wegener's Granulomatosis
      2. Churg-Strauss Syndrome
      3. Microscopic Polyangiitis
      4. Henoch-Schonlein Purpura
      5. Essential Cryoglobulinemia
      6. Cutaneous leuokocytoclastic vasculitis
  4. Associated Conditions
    1. Headache
    2. Sinusitis
    3. Mononeuritis multiplex
    4. Cerebrovascular Accident
    5. Hematuria
  5. Signs: General
    1. Fever
    2. Hypertension
    3. Weight loss
    4. Rales on pulmonary exam
    5. Hepatomegaly or Splenomegaly
    6. Palpable peripheral nerves
    7. Skin findings (see specific findings based on type below)
      1. Superficial thrombophlebitis
      2. Skin Ulcerations
  6. Signs: Specific findings based on type
    1. Large Vessel Vasculitis
      1. Arterial Bruit
      2. Pulsation loss
    2. Medium Vessel Vasculitis
      1. Nodules
      2. Necrotizing livedo reticularis
    3. Small Vessel Vasculitis
      1. Palpable Purpura
      2. Urticaria
  7. Labs
    1. Cutaneous lesional Punch Biopsy is single most important study
      1. Biopsy the most characteristic, early active lesions
      2. Send for histopathology and direct immunofluorescence
    2. Inflammatory markers and Infectious disease testing
      1. Complete Blood Count (CBC)
      2. Erythrocyte Sedimentation Rate (ESR)
      3. C-Reactive Protein (C-RP)
      4. Blood Culture
      5. Site-specific culture
    3. Renal tests
      1. Urinalysis
      2. Serum Creatinine
      3. Blood Urea Nitrogen (BUN)
      4. Creatinine phosphokinase (CPK)
    4. Hepatic tests
      1. Liver Function Tests (hepatic panel)
      2. Hepatitis B Surface Antigen
      3. Hepatitis C Antibody
      4. Cryoglobulin
    5. Rheumatologic tests
      1. Antinuclear Antibody
      2. Serum complement
      3. Anti-dsDNA
      4. Extractable nuclear antigen
      5. Antineutrophil cytoplasmic autoantibodies (ANCA)
  8. Imaging
    1. Sinus XRay or Sinus CT
    2. Chest XRay or Chest CT
  9. Diagnostics
    1. Electrocardiogram
    2. Echocardiogram
    3. Electromyogram (EMG)
  10. References
    1. Bohjanen (2009) UMN CME Internal Medicine Review, Minneapolis
    2. Jennette (1994) Arthritis Rheum 37:187

Vasculitis (C0042384)

Definition (MSH)Inflammation of any one of the blood vessels, including the ARTERIES; VEINS; and rest of the vasculature system in the body.
Definition (CSP)inflammation of a blood vessel.
Definition (NCI)Inflammation of a blood vessel.
ConceptsDisease or Syndrome (T047)
MSHD014657
EnglishAngiitides, Angiitis, vascular inflammation or infection, Vasculitides, Vasculitis
Spanishangitis, vasculitis
Parent ConceptsExaminer's Diagnosis (C0178413), Vascular Diseases (C0042373), COLLAGEN VASCULAR DISEASE (C0262428), Vascular Disorders, General and NEC (C0549519), Non-Neoplastic Vascular Disorder (C1335053), Inflammation of specific body organs (C1285331), Inflammatory disorder of the cardiovascular system (C1290889), Duplicate concept (C1274013)
SourcesAIR, AOD, COSTAR, CSP, CST, DXP, LCH, MEDLINEPLUS, MSH, MTH, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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