Vasculitides
First Things First (assess & treat for the following)
- Vasculitic syndromes are characterized by inflammation & necrosis of blood vessel walls, resulting in narrowing or occlusion of the lumen or formation of aneurysms.
- Sequelae of anatomic changes include ischemia, infarction, turbulent flow and/or bleeding from aneurysmal rupture.
- Blood vessels anywhere throughout the body can be affected, but the extent & site of vessel involvement vary considerably in different cases & syndromes.
- Vascular involvement tends to be irregular & segmental rather than continuous.
- The vasculitides have in common vascular inflammation, yet there are different types & presentations. They could be isolated (skin, retina, CNS, etc.); they can be systemic (multiple organ involvement); they can be acute w/ all lesions at same stage or chronic w/ lesions at different stages of inflammation.
- Prognosis is variable: some have a benign self-limited course (ie, Henoch-Schönlein purpura [HSP]); others can be life- or organ-threatening w/ fatal prognosis if untreated (ie, Wegener’s).
- Pathogenic mechanisms are varied & complex. Vessel damage can be mediated by:
- Immune complex deposition
- Antiendothelial cell antibodies
- Antibodies against lysosomal enzymes
- Pathogenic cellular immune response & granuloma formation
- Infection agents, tumor cells, drugs
- Classification: vasculitides are grouped according to size of predominant blood vessels involved.
- Large vessel vasculitis
- Takayasu’s arteritis (TA)
- Giant cell (temporal) arteritis (GCA)
- Medium vessel vasculitis
- Polyarteritis nodosa (PAN)
- Kawasaki’s disease
- Isolated CNS vasculitis
- Small vessel vasculitis; Also known as hypersensitivity/allergic vasculitis or leukocytoclastic vasculitis.
- Anti-GBM disease
- ANCA-associated syndromes: Wegener’s granulomatosis (WG), microscopic polyangiitis, Churg-Strauss syndrome (CSS), pauci-immune necrotizing crescentic glomerulonephritis (GN)
- Cryoglobulinemic vasculitis (hepatitis C)
- HSP
- Primary cutaneous leukocytoclastic angiitis: drugs, infectious, malignancy, autoimmune
- Hypocomplementemic urticarial vasculitis
- Thromboangiitis obliterans (Buerger’s disease) not a true vasculitis
- Large vessel vasculitis
- Pathogenic mechanisms are varied & complex. Vessel damage can be mediated by:
There's more to see -- the rest of this topic is available only to subscribers.
Last updated: May 17, 2010
Citation
"Vasculitides." Pocket ICU Management, PocketMedicine.com, Inc, 2010. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534182/all/Vasculitides.
Vasculitides. Pocket ICU Management. PocketMedicine.com, Inc; 2010. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534182/all/Vasculitides. Accessed November 22, 2024.
Vasculitides. (2010). In Pocket ICU Management. PocketMedicine.com, Inc. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534182/all/Vasculitides
Vasculitides [Internet]. In: Pocket ICU Management. PocketMedicine.com, Inc; 2010. [cited 2024 November 22]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534182/all/Vasculitides.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Vasculitides
ID - 534182
Y1 - 2010/05/17/
BT - Pocket ICU Management
UR - https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534182/all/Vasculitides
PB - PocketMedicine.com, Inc
DB - Anesthesia Central
DP - Unbound Medicine
ER -