Presentation
It is the purpose of this paper to present this case and to discuss some problems concerning genesis of symptoms of temporal arteritis. [ncbi.nlm.nih.gov]
Of these 12 at least 8 have presented with a similar symptomatology. Etiologic theories are discussed, and suggestions are made as to the possible management of infants presenting a similar diagnostic problem. Received November 3, 1958. [pediatrics.aappublications.org]
Disorders that present with pulmonary-renal syndrome, a combination of RPGN and DAH, include AAV, SLE, and Goodpasture's syndrome. RPGN is nearly always present in MPA, only rarely in EGPA, and sometimes in GPA. [clinicaladvisor.com]
Entire Body System
- Weakness
Emergency symptoms include: Changes in pupil size Loss of function of an arm, leg, or other body part Speech problems Swallowing difficulty Weakness Severe abdominal pain There is no known way to prevent this disorder. Habif TP. [medlineplus.gov]
Emergency symptoms include: Changes in pupil size Loss of function of an arm, leg, or other body part Speech problems Swallowing difficulty Weakness Severe abdominal pain Prevention There is no known way to prevent this disorder. [ufhealth.org]
[…] arteritis risk if you don't treat temporal (giant cell) arteritis granulomatous vasculitis that involves aortic arch at branch points age group of takayasu arteritis younger than 50 - Asian females symptoms of takayasu arteritis 1. visual 2. neurologic 3. weak [quizlet.com]
Patients typically present with fever, fatigue, night sweats, loss of appetite, weight loss, and generalized weakness. Myalgias with areas of focal ischemic myositis and arthralgias are common. Affected muscles are tender and may be weak. [msdmanuals.com]
Focal lesions indicate only part of the wall is involved which may become weak, leading to aneurysm formation which may be followed by rupture. [lupusuk.org.uk]
- Gangrene
[…] aspirin and IVIG (intravenous immunoglobulin) which artery involvement in kawasaki disease coronary artery -> thrombosis with myocardial infarction aneurysm with rupture necrotizing vasculitis involving digits symptoms of buerger disease ulceration gangrene [quizlet.com]
Cutaneous: Livedo reticularis, skin ulcers, tender erythematous nodules, bullous or vesicular eruptions, infarction and gangrene of fingers or toes, or a combination may occur. [msdmanuals.com]
Systemic vasculitis complicating lupus will often present with severe skin rashes which may be necrotic leading to gangrene. [lupusuk.org.uk]
Detection of cytomegalovirus antigens in phagocytosed serum complexes from a patient with rheumatoid arthritis, vasculitis, peripheral neuropathy, cutaneous ulceration, and digital gangrene. Ann Rheum Dis, 51 (1992), pp. 553-555 Copyright © 2012. [bjid.org.br]
Areas of skin totally deprived of blood flow, and therefore of oxygen, may die, resulting in blackened areas of gangrene. The joints. In addition to joint pain, the joints themselves may become inflamed, resulting in arthritis. [medical-dictionary.thefreedictionary.com]
- Pathologist
Edited by four leading surgical pathologists - Noel Weidner, MD, Richard J. Cote, MD, Saul Suster, MD and Lawrence M. [books.google.com]
©1998International Society of Gynecological Pathologists [journals.lww.com]
Respiratoric
- Pneumonia
Four (15%) patients died in the ICU, three of septic shock caused by Pseudomonas aeruginosa ( n = 1), S. aureus ( n = 1) pneumonia or urinary tract infection ( E. coli, n = 1). [academic.oup.com]
Anderson JL, Muhlestein JB, Carlquist J, Allen A, Trehan S, Nielson C, Hall S, Brady J, Egger M, Hörne B, Lim T (1999) Randomized secondary prevention trial of azithromycin in patients with coronary artery disease and serological evidence for Chlamydia pneumoniae [books.google.com]
Various organ involvements (eg: encephalitis, meningitis, retinitis, myocarditis, pneumonia, hepatitis, enterocolitis, neuritis), which rarely occur in immunocompetent patients, have also been reported. [bjid.org.br]
Patients receiving glucocorticoids in combination with methotrexate or cyclophosphamide should be treated with T/S three times weekly to reduce the risk for P. carinii pneumonia. [lupusinternational.com]
Inflammation of the pulmonary artery and lobular pneumonia followed by phlebitis. In: Long BR, editor. Selected Readings in Pathology. London: Baillière Tindal and Cox; 1929. Google Scholar Aksu K, Donmez A, Keser G. [thrombosisjournal.biomedcentral.com]
Skin
- Palpable Purpura
Physical exam Palpable purpura is pathognomonic for vasculitis. Palpable purpura consists of elevated, nonblanching erythematous lesions. [bobbybukamd.com]
Classification criteria for Henoch-Schönlein purpura include palpable purpura (mandatory criterion) in the presence of at least one of following 4 features: Diffuse abdominal pain Any biopsy finding that reveals predominant lgA deposition Arthritis or [emedicine.medscape.com]
Palpable purpura. If patients have this in isolation, it is most likely due to cutaneous leukocytoclastic vasculitis. [en.wikipedia.org]
[…] age group symptoms of Henoch Schonlein Purpura 1. palpable purpura on buttocks and legs 2. [quizlet.com]
purpura, polyarthralgia, glomerulonephritis Cutaneous leukocytoclastic angiitis Skin Any age Palpable purpura, cutaneous infarcts, necrotic papules, urticaria Henoch-Schönlein purpura Skin, gastrointestinal tract, kidney, joint 3 to 8 Purpura, arthritis [aafp.org]
- Skin Ulcer
Cutaneous: Livedo reticularis, skin ulcers, tender erythematous nodules, bullous or vesicular eruptions, infarction and gangrene of fingers or toes, or a combination may occur. [msdmanuals.com]
It can produce deep dermal ulcers, localized skin infarction, ischemia or necrosis of the fingertips, scleritis, and inflammation of multiple nerves (mononeuritis multiplex). vasculitis Widespread inflammation of blood vessels occurring as the principal [medical-dictionary.thefreedictionary.com]
Infections of chronic, deep skin ulcers have led to death from sepsis. Some investigators have postulated that HCV-related type II MC is a benign of low-grade B-cell lymphoproliferative disease. [lupusinternational.com]
- Subcutaneous Nodule
[…] and subcutaneous fat. [msdmanuals.com]
Medium-vessel vasculitis can present with subcutaneous nodules, erythematous nodules, deep ulcers, livedo reticularis, pitted palmar scars, gangrene of the digits, or infarcts. [bobbybukamd.com]
nodules, other vasculitic lesions) Myalgia or muscle tenderness Systemic hypertension, relative to childhood normative data Mononeuropathy or polyneuropathy Abnormal urine analysis and/or impaired renal function (glomerular filtration rate of < 50% normal [emedicine.medscape.com]
- Papule
[…] erythema multiforme Fibrin thrombi: present in segmented, hyalinizing vasculitis Infarct of skin: associated with malignant atrophic papulosis (Dego's disease); intimal proliferation of deep-seated arteriole Purpura: non-blanching, erythematous macules or papules [pathologyoutlines.com]
Lesions may begin as macular erythema or urticaria that develops into nonblanching erythematous macules and papules. [bobbybukamd.com]
[…] rhinitis, asthma, peripheral eosinophilia Cryoglobulinemic vasculitis Skin, kidney 40 to 50 Recurrent palpable purpura, polyarthralgia, glomerulonephritis Cutaneous leukocytoclastic angiitis Skin Any age Palpable purpura, cutaneous infarcts, necrotic papules [aafp.org]
Urogenital
- Oliguria
Renal: If small- and medium-sized arteries in the kidneys are affected, patients may have hypertension, oliguria, uremia, and a nonspecific urinary sediment with hematuria, proteinuria, and no cellular casts. Hypertension may worsen rapidly. [msdmanuals.com]
Neurologic
- Irritability
Other manifestations may include irritability, arthritis, and abdominal pain. [emedicine.medscape.com]
Some forms of vasculitis may be due to allergic reactions or hypersensitivity to certain medications such as sulfur drugs, penicillin, propylthiouracil, other drugs, toxins, or other inhaled environmental irritants. [rarediseases.org]
Acrolein, a toxic metabolite of cyclophosphamide, can irritate the bladder and promote hemorrhagic cystitis, bladder fibrosis, and transitional and squamous cell carncinoma. Two preventive measures may lessen the frequency of bladder complications. [lupusinternational.com]
- Seizure
CNS: Headache and seizures can result. In a few patients, ischemic stroke and cerebral hemorrhage occur, sometimes resulting from hypertension. [msdmanuals.com]
Inflammation of the blood vessels in the brain can cause headaches, changes in personality, confusion, and seizures. If an area of the brain becomes totally deprived of oxygen, a stroke occurs. [medical-dictionary.thefreedictionary.com]
□ Creatinine clearance decrease of > 25 percent □ Hematuria (≥ 10 red blood cells per high-power field) □ Hypertension □ Proteinuria > 1+ □ Nervous system □ Cord lesion □ Cranial nerve palsy □ Headache □ Meningitis □ Motor mononeuritis multiplex □ Seizures [aafp.org]
Workup
Progress logically from the histologic pattern, through the appropriate workup, around the pitfalls, to the best diagnosis. [books.google.com]
DAH in conjunction with other manifestations of systemic vasculitis (see section below on common findings) should trigger a workup to establish a diagnosis. [clinicaladvisor.com]
Treatment
545 Dialysis ultrafiltration and hemofiltration 555 Use of drugs in uremia and dialysis 567 Donor and recipient selection in renal transplantation 587 Immunosuppression and treatment of rejection in renal transplantation 595 XIII 606 Renal tubular and [books.google.com]
However, it is sometimes difficult to set a boundary between severe cPAN and systemic PAN, and their optimal treatments are still unclear. [acrabstracts.org]
TREATMENT STUDIES Prompt treatment of interstitial keratitis with topical glucocorticoids usually prevents corneal scarring and vascularization. [lupusinternational.com]
Improved treatment has dramatically improved the survival but there is still significant morbidity from the disease (and/or its treatment). An understanding of the different types of vasculitis is helped by understanding classification. [lupusuk.org.uk]
Prognosis
The vasculitides represent a heterogenous set of disorders that differ in prognosis and response to therapy. [ncbi.nlm.nih.gov]
For example, a patient with purpura, nephritis, and abdominal pain caused by Henoch–Schönlein purpura usually has a good prognosis. .. [nejm.org]
Prognosis is better if disease remission is achieved within 18 months after diagnosis. Relapses are less common than in other vasculitic disorders. [msdmanuals.com]
What is the Prognosis of Necrotizing Vasculitis? (Outcomes/Resolutions) Outcomes for individuals with necrotizing vasculitis greatly vary depending on the location of inflammation and the severity of tissue damage. [dovemed.com]
Outlook (Prognosis) The outcome depends on the location of the vasculitis and the severity of tissue damage. [ufhealth.org]
Etiology
Etiologic theories are discussed, and suggestions are made as to the possible management of infants presenting a similar diagnostic problem. Received November 3, 1958. Accepted December 10, 1958. [pediatrics.aappublications.org]
Although the etiology is unclear, these clinical and epidemiological relations suggest that these patients form a distinct entity and that our concepts of necrotizing vasculitis should be broadened. FULL TEXT [annals.org]
These protean clinical manifestations, combined with the etiologic nonspecificity of the histologic lesions, complicate the diagnosis of specific forms of vasculitis. [nejm.org]
[…] vasculitides thought to represent hypersensitivity to an antigenic stimulus, such as a drug, infectious agent, or exogenous or endogenous protein; all disorders in this group involve the small vessels. nodular vasculitis a chronic vasculitis of unknown etiology [medical-dictionary.thefreedictionary.com]
Secondary pulmonary vasculitis can be associated with a number of diverse etiologies, including infection, drug reactions, connective tissue disease, and malignancy. [clinicaladvisor.com]
Epidemiology
Although the etiology is unclear, these clinical and epidemiological relations suggest that these patients form a distinct entity and that our concepts of necrotizing vasculitis should be broadened. FULL TEXT [annals.org]
An epidemiologic and histopathologic analysis. Arthritis Rheum 37: 1007-1012. Nordborg E, Bengtsson BA (1990) Epidemiology of biopsy-proven giant cell arteritis (GCA). J Intern Med 227: 233-236. [omicsonline.org]
Henoch-Schonlein purpura in children from northwestern Spain: a 20-year epidemiologic and clinical study. Medicine 2001;80(5):279-90. [ Links ] 40. Peru H, Soylemezoglu O, Bakkaloglu SA, et al. [scielo.org.mx]
"The epidemiology of the primary systemic vasculitides in northwest Spain: implications of the Chapel Hill Consensus Conference definitions". Arthritis Rheum. 49 (3): 388–93. doi : 10.1002/art.11115. PMID 12794795. ^ Churg J (September 1993). [en.wikipedia.org]
The INSERM Unit 169 of statistical and epidemiological studies: factors related to outcome in intensive care. French Multicenter Study. Crit Care 1989 ; 17 : 305 –8 7 Raffin T. Intensive care unit survival of patients with systemic illness. [academic.oup.com]
Pathophysiology
The differential diagnosis of the lesion is considered, and the pathophysiology of hypertension due to large vessel arteritis is discussed. [ncbi.nlm.nih.gov]
Suzuki H, Kiryluk K, Novak J et al (2011) The pathophysiology of IgA nephropathy. J Am Soc Nephrol 22(10):1795–1803 PubMedCentral PubMed CrossRef Google Scholar 25. [doi.org]
Behcet's syndrome pathophysiology and potential therapeutic targets. Intern Emerg Med. 2014;9:257–65. PubMed Google Scholar Arida A, Fragiadaki K, Giavri E, Sfikakis PP. [thrombosisjournal.biomedcentral.com]
Prevention
Furthermore it seems to be important to be aware of the specificity of focal arteritis in female genital tract as distinct from the generalized form to prevent unnecessary surgical or chemotherapeutical therapy for this lesion. [ncbi.nlm.nih.gov]
Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. [books.google.es]
In cases of tissue infection, antibiotics are used How can Necrotizing Vasculitis be Prevented? Since little is known about the cause of necrotizing vasculitis, there are no known methods of preventing the condition. [dovemed.com]
Emergency symptoms include: Changes in pupil size Loss of function of an arm, leg, or other body part Speech problems Swallowing difficulty Weakness Severe abdominal pain Prevention There is no known way to prevent this disorder. [ufhealth.org]
N Engl J Med الصفحة 339 - Anderson JL, Muhlestein JB, Carlquist J, Allen A, Trehan S, Nielson C, Hall S, Brady J, Egger M, Hörne B, Lim T (1999) Randomized secondary prevention trial of azithromycin in patients with coronary artery disease and serological [books.google.com]