Small-sized vessel vasculitis with fever, headache, weight loss, arthralgia, and claudication
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Abbreviations: ABG= Arterial blood gas, ANA= Antinuclear antibody, ANP= Atrial natriuretic peptide, ASO= Antistreptolysin O antibody, BNP= Brain natriuretic peptide, CBC= Complete blood count, COPD= Chronic obstructive pulmonary disease, CRP= C-reactive protein, CT= Computed tomography, CXR= Chest X-ray, DVT= Deep vein thrombosis, ESR= Erythrocyte sedimentation rate, HRCT= High Resolution CT, IgE= Immunoglobulin E, LDH= Lactate dehydrogenase, PCWP= Pulmonary capillary wedge pressure, PCR= Polymerase chain reaction, PFT= Pulmonary function test.
Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | |||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Physical examination | ||||||||||||||||||||
Lab Findings | Imaging | Histopathology | |||||||||||||||||||
Headache | Fever | Weight loss | Arthralgia | Claudication | Bruit | HTN | Focal neurological disorder | Biomarker | CBC | ESR | Other | CT scan | Angiography | Ultrasound/ Echocardiography | Other | ||||||
Small-Vessel Vasculitis | Hematologic disease | Chronic Lymphocytic Leukemia (CLL)[1] | + | + | + | + | +/- | - | - | +/- | CD5, CD19, CD20, IgVH | Absolute lymphocytosis, Smudge cells | ↑ | Flow cytometry | Staging | - | - | - | Large atypical cells, cleaved cells, and prolymphocytes | Chromosomal and genetic testing | Easy bruising |
Non-Hodgkin Lymphoma[2] | + | + | + | + | +/- | +/- | +/- | +/- | MYC, BCL2, BCL6, and TP53 | Lymphocytosis, Anemia, Thrombocytopenia | ↑ | ↑Lactate dehydrogenase (LDH), Hypercalcemia | Enlarged lymph nodes, Hepatosplenomegaly, Filling defects in the liver and spleen | - | Hepatosplenomegaly | Mediastinal lymphadenopathy | Small cleaved or noncleaved, intermediate, or large cell with a follicular or diffuse pattern | Surgically excised tissue biopsy | Easy bruising, Testicular mass, Skin lesion | ||
Systemic disease | Systemic lupus erythematosus[3] | + | + | + | + | +/- | - | + | + | Anti dsDNA, ANA | Leukopenia, Lymphopenia, Anemia, Thrombocytopenia | ↑ | ↑Cr or BUN,
↑ALT or AST, Proteinuria |
Interstitial lung disease, Pneumonitis, Pulmonary emboli, Alveolar hemorrhage | Aneurysms | Pericardial effusion, pulmonary hypertension, or verrucous Libman-Sacks endocarditis in echocardiography | Central nervous system (CNS) lupus white-matter changes in MRI | Staging lupus nephritis | Anti-dsDNA antibody test | Skin rashes or photosensitivity | |
Rheumatoid arthritis[4] | +/- | +/- | + | + | + | + | - | - | RF, Anti-CCP antibody | Anemia | ↑ | ↑Cr or BUN, | Microfractures | Aneurysms | Effusions in joints | Basilar invagination with cranial migration of an eroded odontoid peg in MRI | Influx of inflammatory cells into the synovial membrane, with angiogenesis, proliferation of chronic inflammatory cells | Clinical findings coupled anti-CCP antibody | Rheumatoid nodules |
References
- ↑ Byrd JC, Stilgenbauer S, Flinn IW (2004). "Chronic lymphocytic leukemia". Hematology Am Soc Hematol Educ Program: 163–83. doi:10.1182/asheducation-2004.1.163. PMID 15561682.
- ↑ Shankland KR, Armitage JO, Hancock BW (September 2012). "Non-Hodgkin lymphoma". Lancet. 380 (9844): 848–57. doi:10.1016/S0140-6736(12)60605-9. PMID 22835603.
- ↑ Tsokos, George C. (2011). "Systemic Lupus Erythematosus". New England Journal of Medicine. 365 (22): 2110–2121. doi:10.1056/NEJMra1100359. ISSN 0028-4793.
- ↑ Scott JT (1991). "The gold standard in rheumatoid arthritis". J R Soc Med. 84 (9): 513–4. PMC 1293405. PMID 1682491.