Vasculitis pathophysiology: Difference between revisions

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==Pathophysiology==
==Pathophysiology==
===Large vessel vasculitis===
* [[Takayasu arteritis]] - Primarily affects the [[aorta]] and its main branches.
* [[temporal arteritis|Giant cell (temporal) arteritis]] - Chronic vasculitis of both large and medium vessels, primarily affecting cranial branches of the arteries arising from the aortic arch.
===Medium vessel vasculitis===
* [[Polyarteritis nodosa]] - Systemic necrotizing vasculitis and [[aneurysm]] formation affecting both medium and small arteries. If only small vessels are affected, it is called microscopic polyangiitis, although it is more associated with [[Wegener's granulomatosis]] than to classic [[PAN]].
* [[Wegener's granulomatosis]] - Systemic vasculitis of medium and small arteries, including venules and arterioles. Produces granulomatous inflammation of the respiratory tracts and necrotizing, pauci-immune glomerulonephritis. Most common cause of saddle nose deformity in USA (nose flattened due to destruction of nasal septum by granulomatous inflammation).
* [[Kawasaki disease]] - Usually in children, it affects large, medium, and small vessels, prominently the coronary arteries. Associated with a mucocutaneous lymph node syndrome.
* Isolated CNS vasculitis - Affects medium and small arteries over a diffuse CNS area, without symptomatic extracranial vessel involvement.
===Small vessel vasculitis===
* [[Churg-Strauss syndrome|Churg-Strauss arteritis]] - Affects medium and small vessels with vascular and extravascular granulomatosis. Classically involves arteries of lungs and skin, but may be generalized.
* [[microscopic polyangiitis|Microscopic polyarteritis/polyangiitis]] - Affects [[capillaries]], [[venules]], or [[arterioles]]. Thought to be part of a group that includes [[Wegeners]] since both are associated with [[ANCA]] and similar extrapulmonary manifestations. Patients do not usually have symptomatic or histologic respiratory involvement.
* [[Hypersensitivity vasculitis]] - Usually due to a [[hypersensitivity]] reaction to a known drug. There is presence of skin vaculitis with palpable [[petechiae]] or [[purpura]]. Biopsy of these lesions reveal inflammation of the small vessels, termed leukocytoclastic vasculitis, which is most prominent in postcapillary venules.
* [[Henoch-Schonlein purpura]] - Systemic vasculitis due to tissue deposition of [[IgA]]-containing immune complexes. Biopsy of lesions shows inflammation of small vessels. It is considered a form of hypersensitivity vasculitis but is distinguished by prominent deposits of IgA. This is the most common vasculitis in children.
* [[Essential cryoglobulinemic vasculitis]] - Most often due to [[hepatitis C infection]], immune complexes of [[cryoglobulins]] --- proteins that consists of [[immunoglobulins]] and [[complement]] and precipitate in the cold while dissolving upon rewarming --- are deposited in walls of capillaries, venules, or arterioles.
* Vasculitis secondary to connective tissue disorders - Usually secondary to [[lupus erythematosus| systemic lupus erythematosus]] (SLE), [[rheumatoid arthritis]] (RA), relapsing [[polychondritis]], [[Behcet's disease]], and other connective tissue disorders.
* Vasculitis secondary to viral infection
===Gross Pathology===
{| align="left"
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| [[Image:Kidney petechia 1.jpg|thumb|Kidney: Petechiae: Gross natural color, an excellent example of flea bitten kidney case had necrotizing vasculitis]]
| [[Image:Leucocytoclastic vasculitis 2.jpg|thumb|Skin:Leucocytolastic vasculitis; legs]]
| [[Image:Leucocytoclastic vasculitis pustular type.jpg|thumb|Leucocytoclastic vasculitis; pustular type]]
|}
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{| align="left"
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| [[Image:Skin vasculitis.jpg|thumb|Vasculitis: In this instance, the vasculitic skin lesions were secondary to Haemophilus endocarditis.]]
| [[Image:Skin vasculitis2.jpg|thumb|Vasculitis: In this instance, the vasculitic skin lesions were secondary to Haemophilus endocarditis.]]
| [[Image:Skin vasculitis4.jpg|thumb|Vasculitis: In this instance, idiopathic with palpable purpura.]]
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{| align="left"
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| [[Image:skin_vasculitis6.jpg|thumb|Vasculitis: Palpable Purpura: Secondary to idiopathic leukocytoplastic vasculitis.]]
| [[Image:Skin_vasculitis7.jpg|thumb|Vasculitis: In this instance, idiopathic.]]
| [[Image:skin_vasculitis5.jpg|thumb|Vasculitis: In this instance, idiopathic with palpable purpura.]]
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===Microscopic Pathology===
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| [[Image:Acute vasculitis due to transplant rejection 2.jpg|thumb|Kidney: Transplant: Micro H&E high mag excellent example acute vasculitis due to rejection ]]
| [[Image:Coronary artery vasculitis due to transplant rejection 1.jpg|thumb|Coronary artery: Transplant Rejection: Micro high mag H&E small muscular artery vasculitis ]]
| [[Image:Ricketsia vasculitis.jpg|thumb|Vasculitis, Rocky Mountain Spotted Fever, immunoperoxidase staining vessels for Rickettsia rickettsii]]
| [[Image:Leucocytoclastic vasculitis 1.jpg|thumb|Skin:Leucocytolastic vasculitis; a close up view]]
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Rheumatology]]


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Latest revision as of 19:55, 31 January 2018