Objectives What is a vasculitis Know the more common and relevant vasulitides Understand how to investigate and manage these conditions Case scenario Definition Multisystem Inflammatory disorder of blood vessels with systemic and system specific symptoms ID: 235575
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Slide1
VasculitisSlide2
Objectives
What is a
vasculitis
Know the more common and relevant
vasulitides
.
Understand how to investigate and manage these conditions.
Case scenario.Slide3
Definition
Multi-system Inflammatory disorder of blood vessels, with systemic and system specific symptoms.Slide4
Categories
Large Vessel
PMR
Giant cell/temporal
Medium Vessel
Polyarteritis
nodosum
Kawasaki’s disease
Small vessel
Churg
Strauss
Wegener’s
Henoch-schonlein
purpuraSlide5
Finals cases
Written
Any of them
Clinical
PMR (Giant cell)
Wegener’s
Churg
StraussSlide6
Recognising Symptoms
All: fatigue, fever, weight loss, anaemia
PMR:
Pain+stiffness
in muscles.
Giant cell: temporal tenderness, headache, jaw
claudication
,
Amaurosis
fugax
.Slide7
Wegener’s: chronic rhinitis, saddle nose deformity. Cough, haemoptysis, arthritis. Eventually renal impairment.
Churg
-Strauss: Asthma
heart disease OR skin lesions/nasal polyps.Slide8
Ix
Bedside – Urine dip
Bloods – U+Es, FBC, LFTs,
- CRP, ESR, ANCA
Imaging – depends on symptoms
Special tests - biopsySlide9
Rx
Conservative – Advice
Medical – Steroids,
immunosuppressants
(
azathioprine
,
cyclophosphamide
)Slide10
Case
45
year old man comes to see you with a stuffy nose for the last 5 months. He is troubled by recurrent sinusitis and runny nose. He also feels his nose has changed shape, as if it has “caved in”. He has felt generally unwell with aches and tiredness for the last 3 months. The reason he has come today is that he coughed up blood yesterday and is worried it means he has cancer. On examination his temp is 37.3. He has mild
conjunctival
pallor and
a
deformity of his nose. Systemic examination is otherwise unremarkable. You send off some routine bloods and his urea come back at 17 and his
creatinine
at 350.Slide11Slide12
Questions
What are your main differentials for this man?
How
will you investigate him?
How
will you manage him?
What
is the classification for
vasculitis
? Give examples
of
each group
What
are the ANCA positive
vasculitides
?Slide13
Summary
State the obvious
Large medium and
small vessel
Multi-system Inflammatory disorder of blood vessels, with systemic and system specific symptoms