Coupon Accepted Successfully!


Vasculitis: A Group of Disorders Characterized By Inflammation & Necrosis of Blood Vessels [Arteries, Veins or Both]

  1. The Acr Classification Criteria For Vasculitis
    Giant-cell (temporal) arteritis (CGA)
    1. Age >50y at onset
    2. New type of headache
    3. Abnormal temporal artery on clinical examination (Tenderness to palpation or decreased pulsation)
    4. Elevated erythrocyte sedimentation rate
    5. Temporal artery biopsy showing vasculitis
  2. Three Criteria Classify Cga With Sensitivity of 95-5% and Specificity of 91.2%
    Takayasu's arteritis (TA)
    1. Age less than 40 yr at onset         
    2. Limb claudication
    3. Decreased brachial artery pulses                  
    4. BP >10 m Hg difference between two arms
    5. Bruits                                          
    6. Arteriogram abnormal
  3. Three Criteria Classify Ta with Sensitivity of 90.5% and Specificity of 97.8%
    Polyarterllis nodosa (PAN) – Medium Versel vasculitis
    1. Weight loss >4kg
    2. Livedo reticularis
    3. Testicular pain or tenderness
    4. Myalgias, myopathy or tenderness
    5. Neuropathy
    6. Hypertension (diastolic BP >90 mm Hg)
    7. Renal impairment (elevated BUN or creatinine)
    8. Hepatitis B virus
    9. Abnormal arteriography
    10. Biopsy of artery showing PMN
Three criteria classify PAN with sensitivity of 82.2% and specifically of 86.6%
  1. Wegner's Granulomatosis (WG) – C-ANCA POSITIVE + VE
    1. Nasal or oral inflammation
    2. Chest x-ray showing nodules, infiltrates (fixed or cavities)
    3. Microscopic hematuria or red cell casts in urine
    4. Granulomatous inflammation on biopsy (within vessel wall or perivascular)
Two criteria classify WG with sensitivity of 88.2% and specificity of 92.0%
  1. Churg-Strauss Syndrome (CSS)
    1. Asthma
    2. Eosinophilia (>10%)
    3. Neuropathy
    4. Pulmonary infiltrates (nonfixed)
    5. Sinusitis
    6. Extravascular eosinophils on biopsy
Four criteria classify CSS with sensitivity of 85% and specificity of 99.7%
  1. Hypersensitivity Vasculitis
    1. Age > loyal onset
    2. Medications that may have precipitated event
    3. Palpable purpura
    4. Cutaneous eruption
    5. Positive biopsy results
      Three criteria classify HSV with sensitivity of 71,0% and specificity of 83.9%
  2. Henoch-Schönlein Purpura (HSP)
    1. Palpable purpura
    2. Age at onset <20y
    3. Bowel angina
    4. Vessel wall granulocytes on biopsy
Two criteria classify HSP with sensitivity of 87% and specificity of 88%
  1. The Chcc Definitions of Vasculitis
    1. Large-vessel vasculitis
      1. Giant cell (temporal) arteritis: Granulomatous arteritis of the aorta and its major branches, with a predilection for the extracranial branches of the carotid artery, often involves the temporal artery; usually occurs in patients older than 50y and is often associated with polymyalgia rheumatica
      2. Takayasu arteritis: Neuromatous inflammation of the aorta and its major branches usually occurs in patients younger than 50y.
    2. Medium-sized vessel vasculitis
      1. Polyarteritis nodosa (classic PAN): Necrotizing inflammation of medium-sized or small arteries without glomerulonephritis or vasculitis in arterioles, capillaries or venules
      2. Kawasaki disease: Arteritis involving large, medium-sized or small arteries and associated with Mucocutaneous lymph node syndrome; coronary arteries are often involved; aorta and veins may be involved; usually occurs in children:
    3. Small-vessel vasculitis
      1. Wegner's granulomatosis: Granulomatous inflammation involving the respiratory tract, and necrotizing vasculitis affecting small to medium-sized vessels (eg. Capillaries, venules, arterioles, and arteries); necrotizing glomerulonephritis is common.
      2. Churg-Strauss syndrome: Eosinophil-rich and granulomatous inflammation involving the respiratory tract, necrotizing vasculitis affecting small to medium-sized vessels, and associated with asthma and eosinophilia
      3. Microscopic polyangiitis: Necrotizing vasculitis, with few or no immune deposits, affecting small vessels (ie, capillaries, venules, or arterioles); necrotizing arteritis involving small and medium-sized arteries may he present; necrotizing glomerulonephritis is very common; pulmonary capillaritis often occurs
      4. Henoch-Schönlein purpura: Vasculitis, with IgA-dominant immune deposits, affecting small vessels (ie. Capillaries, venules, or arterioles); typically involves skin, gut, and glomeruli and is associated with arthralgias or arthritis.
      5. Essential cryoglobulinemia vasculitis: Vasculitis, with cryoglobulin immune deposits, affecting small vessels (ie. Capillaries, venules, or arterioles), and associated with cryoglobulins in serum; skin and glomeruli are often involved.
      6. Cutaneous leukocytoclastic angiitis: Isolated cutaneous leukocytoclastic angiitis without systemic vasculitis or glomerulonephritis.

Test Your Skills Now!
Take a Quiz now
Reviewer Name