Name three traits describing the population commonly affected by Takayasu arteritis
1. ~young (15-45 years of age)
2. asian heritage
3. females
Takayasu arteritis is a large vessel vasculiitis that effects the aorta and its major branches --> symptoms are based off of what branches are affected; when the branch that feeds the upper extremities is affected it will lead to weak or no pulse, if it affects vessels going towards the head it can produce visual or neurological symptoms
What vasculitis is called the pulseless disease?
Takayasu arteritis (I can't TAKA YA pulse)
Takayasu arteritis is a large vessel vasculiitis that effects the aorta and its major branches --> symptoms are based off of what branches are affected; when the branch that feeds the upper extremities is affected it will lead to weak or no pulse, if it affects vessels going towards the head it can produce visual or neurological symptoms
What organ is usually spared in polyarteritis nodosa?
The Lungs!!!
polyarteritis nodosa is a vasculitis of small and medium vessels that leads to tissue ischemia commonly involving skin, nerves, muscles, joints, GI tract, and kidneys but spares the lungs
polyarteritis nodosa is associated with Hep B; immune cells attack the endothelium which is confused for Hep B and this leads to transmural fibrosis and necrosis
what vasculitis is this?!
Giant Cell arteritis also known as temporal arteritis. In the image we are seeing a very prominent temporal artery
Giant cell arteritis causes chronic inflammation of large vessels, in particular the carotid arteries, its major branches, and the aorta. Giant cell arteritis common effects women over 70 (giants of age), and 50% of patient will also have polymyalgia rheumatica.
Patients will commonly present with constitutional symptoms, new-onset headache, jaw claudication, and a hardened temporal artery.
What vasculitis is strongly associated with hepatitis C infection?
>90 % of Cryoglobulinemic vasculitis are associated with hep C infection
formation of hep C IgG and IgM rheumatoid factor can form immune complexes with hepatitis C antigen which leads to complements activation and inflammation of the blood vessel
Skin and renal biopsy can both show cryoglobulin deposits
What vasculitis is characterized by the following tetrad of clinical findings: palpable purpura, arthralgias, GI symptoms, and renal disease?
IgA vasculitis - typically presents in a child younger than 10 that presents with abdominal pain, arthralgia, and purpura after an infection.
IgA immune complexes in vascular walls activate the complement system leading to vascular inflammation and damage
what are the differences between Granulomatosis with Polyangiitis and Microscopic Polyangiitis?
The presentation of microscopic polyangiitis is similar to that of Wegener granulomatosis, but it does not affect vessels in the upper and lower respiratory tract (no sinusitis or rhinitis), does not involve granuloma formation, and is associated with pANCA, not cANCA.
Both diseases present very similar to each other with necrotizing vasculitis of small vessels, constitutional symptoms, potential renal involvement, skin lesions, cardiac involvement, or ocular involvement
what is that?!
these are all typical findings of Kawasaki disease
this is a clinical diagnosis that is common in young children, specifically asian children. the diagnosis requires fever for at least 5 days as well as evidence of some of the symptoms shown in the image
what we are seeing is starting at a, conjunctivitis, 'strawberry tongue', trunk/perineum rash, erythema and edema of hands and feet, reactivation of BCG scar, perianal erythematous desquamation
A 45-year-old man with asthma comes to the physician because of a 1-month history of progressively worsening shortness of breath and cough. He also has a history of chronic sinusitis and foot drop. Current medications include an albuterol inhaler and inhaled corticosteroid. Physical examination shows diffuse wheezing over both lung fields and tender subcutaneous nodules on both elbows. Laboratory studies show a leukocyte count of 23,000/mm3 with 26% eosinophils and a serum creatinine of 1.7 mg/dL. Urine microscopy shows red blood cell casts. What is the most likely diagnosis?
Eosinophilic granulomatosis with polyangiitis
This patient has features of both upper and lower respiratory disease (sinusitis and asthma), peripheral neuropathy (foot drop), peripheral eosinophilia, and glomerulonephritis (RBC casts, elevated creatinine)
A 5-year-old boy is brought to the physician by his parents because of a 4-day history of arthralgia, abdominal pain, and lesions on his arms and legs. Ten days ago, he had an upper respiratory tract infection. A photograph of his right leg is shown. What is the likely diagnosis?
IgA Vasculitis (aka Henoch-Schonlein purpura)
The onset of abdominal pain, arthralgia, and purpura several days after an infection in a child < 10 years of age should raise suspicion of IgA vasculitis, also known as Henoch-Schonlein purpura.