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General Medicine

Vasculitis

Irene J. Tan, MD, FACR Reviewed 06/2019
 


BASICS

DESCRIPTION

An inflammatory disorder of blood vessels 

  • Clinical features result from the destruction of blood vessel walls with subsequent thrombosis, ischemia, bleeding, and/or aneurysm formatio...

DIAGNOSIS

HISTORY

  • Consider age, gender, and ethnicity.

  • Comprehensive medication history

  • Family history of vasculitis

  • Constitutional symptoms: fever, weight loss, malaise, fatigue, diminished appetite, swe...

TREATMENT

GENERAL MEASURES

  • Discontinue offending drug (hypersensitivity vasculitis).

  • Simple observation for mild cases of IgA vasculitis

  • ANCA-associated vasculitis has two-phase treatment: initial induct...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

If significant coronary artery disease is involved in KD, moderate activity restriction may be of benefit. 

Patient Monitoring

Frequent clinical follow-up supported...

REFERENCES

1
Jennette JC, Falk RJ, Bacon PA, et al. 2012 Revised International Chapel Hill Consensus Conference nomenclature of vasculitides. Arthritis Rheum.  2013;65(1):1–11. [View Abstract on O...

ADDITIONAL READING

  • Gatto M, Iaccarino L, Canova M, et al. Pregnancy and vasculitis: a systematic review of the literature. Autoimmun Rev.  2012;11(6–7):A447–A459. [View Abstract on OvidMedline]

  • Le...

CODES

ICD10

  • I77.6 Arteritis, unspecified

  • M31.30 Wegener’s granulomatosis without renal involvement

  • M30.0 Polyarteritis nodosa

  • M31.6 Other giant cell arteritis

  • M31.5 Giant cell arteritis with polymyalgia rh...

CLINICAL PEARLS

  • Suspect vasculitis in patients with a petechial rash, palpable purpura, glomerulonephritis, pulmonary-renal syndrome, intestinal ischemia, or mononeuritis multiplex.

  • Exclude silent rena...

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Related Images
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Vasculitis with petechiae and purpura of lower extremity
Vasculitis with petechiae and purpura of lower extremity
Figure 12-13 Acute necrotizing vasculitis. This specimen is from a testicular biopsy in a patient with polyarteritis nodosa. The biopsy was performed to confirm a provisional clinical diagnosis.
Figure 12-13 Acute necrotizing vasculitis. This specimen is from a testicular biopsy in a patient with polyarteritis nodosa. The biopsy was...
close up of previous patient's lower extremity
close up of previous patient's lower extremity
FIG. 83.11. Cutaneous findings in ANCA-associated vasculitides. A: Purpura in microscopic polyangiitis. B: Splinter hemorrhages in Wegener's granulomatosis.
FIG. 83.11. Cutaneous findings in ANCA-associated vasculitides. A: Purpura in microscopic polyangiitis. B: Splinter hemorrhages in Wegener'...
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