Definition

[1]
Vasculitis is a condition where there is systemic inflammation of vessel walls.

Prevalence

105 per 1 million people (European descent)[2]

Age

>50
[3]
Gender
Females 2x as likely[4]

Aetiology

[5]
There are many types of vasculitis which are classified by the type of vessel affected. They are autoimmune diseases. The most common vasculitis is giant cell arteritis which affects large vessels.

Risk Factors

[6]
  • Age
  • Female
  • Caucasian

Signs and Symptoms

[7]

Large vessel

Medium Vessel

Small Vessel

  • Purpura
  • Ear pain
  • Sinus pain
  • Wheeze

Pathophysiology

[8]
The underlying cause of vasculitis is not well understood. The most important feature is immune related vascular damage.

Investigations

[9]
  • Arterial Biopsy - inflammation, fibroid necrosis
  • ESR - >100mm/hr
  • CRP - raised
  • ANCA (Anti-Neutrophil Cytoplastic Auto antibodies) - positive
  • Urinalysis - proteinuria and haematuria
Diagnosis
[10]
Diagnosis is confirmed with a biopsy

Differentials to rule out

Treatment

[11]

Non-Pharmacological

  • Fracture prevention therapy (related to steroid use)

Pharmacological

Management

[12]
Patients should be made aware of the short term (infection) and long term complications (eg fractures) of corticosteroid use. Patients should be followed up to ensure adequate control and prevention of steroid complications.

Complications

[13]

Disease

Treatment

Prognosis

[14]
Prognosis depends on the type of vasculitis. Most are self-limiting while others can be life threatening but usually responds well to treatment.

See Also

BMJ Best Practice - Systemic Vasculitis
  1. ^ Oxford Handbook of Clinical Medicine - "Vasculitis"
  2. ^ http://link.springer.com/article/10.1007%2Fs11926-005-0036-5
  3. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/520.html
  4. ^ http://www.medscape.com/viewarticle/407580_3
  5. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/520.html
  6. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/520.html
  7. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/520.html
  8. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/520.html
  9. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/520.html
  10. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/520.html
  11. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/520.html
  12. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/520.html
  13. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/520.html
  14. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/520.html