Systemic vasculitis syndrome
| Common presenting features
| Primary treatment
|
| Vasculitis of small vessels |
|
|
| Hypersensitivity vasculitis | Palpable purpura | Often self-limited if offending agent is removed. If isolated to skin, may not require therapy. In more severe cases, moderate- to high-dose corticosteroid therapy may be needed. |
| Henoch-Schönlein purpura | Palpable purpura, arthritis, glomerulonephritis, intestinal ischemia | Often self-limited and requires no treatment. Steroid therapy for some cases of gastrointestinal or renal involvement. |
| Cryoglobulinemia | Arthritis, Raynaud's phenomenon, glomerulonephritis, palpable purpura | Corticosteroids; plasmapheresis for severe involvement. Antiviral therapy required if associated with hepatitis C. |
| Vasculitis of small and medium-sized vessels |
|
|
| Polyarteritis nodosa | Peripheral neuropathy, mononeuritis multiplex, intestinal ischemia, renal ischemia, testicular pain, livedo reticularis | High-dose corticosteroids, often with cytotoxic agents (e.g., cyclophosphamide [Cytoxan]) |
| Microscopic polyangiitis | Pulmonary hemorrhage, glomerulonephritis | High-dose corticosteroids, often with cytotoxic agents (e.g., cyclophosphamide) |
| Churg-Strauss vasculitis | Allergic rhinitis, asthma, eosinophilia, pulmonary infiltrates, coronary arteritis, intestinal ischemia | High-dose corticosteroids, often with cytotoxic agents (e.g., cyclophosphamide) |
| Wegener's granulomatosis | Recurrent epistaxis or sinusitis, pulmonary infiltrates and/or nodules, glomerulonephritis, ocular involvement | High-dose corticosteroids and cyclophosphamide. Corticosteroids and methotrexate may be used for less severe involvement. |
| Kawasaki disease | Fever, conjunctivitis, lymphadenopathy, desquamating rash, mucositis, arthritis, coronary artery aneurysms | High-dose aspirin and intravenous immune globulin |
| Vasculitis of large vessels |
|
|
| Giant cell, or temporal, arteritis | Headache, polymyalgia rheumatica, jaw or tongue claudication, scalp tenderness, fever, vision disturbances | High-dose corticosteroids |
| Takayasu's arteritis | Extremity claudication, athralgias, constitutional symptoms, renal ischemia | High-dose corticosteroids |
POST COMMENT
0 comments:
Post a Comment