Difference between revisions of "Vasculitides"

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Vasculitides (view source)

Revision as of 07:52, 17 December 2014

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→‎Giant cell arteritis: split out
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*Abbreviated ''GCA''.
*Abbreviated ''GCA''.
*[[AKA]] ''temporal arteritis''.
*[[AKA]] ''temporal arteritis''.
===General===
{{Main|Giant cell arteritis}}
*Classically afflicts the ''temporal artery''.
 
Clinical features:
*Classic finding: jaw claudication, in a patient older than 50 years.
*Other findings: headache, vision loss or diplopia, scalp tenderness, polymyalgia, weight loss, chills, fever.
 
Work-up:
*CRP, ESR, temporal artery biopsy.
**ESR normal (>50 years old): <20 mm/hr males, <30 mm/hr females.<ref>URL: [http://www.nlm.nih.gov/medlineplus/ency/article/003638.htm http://www.nlm.nih.gov/medlineplus/ency/article/003638.htm]. Accessed on: 17 August 2012.</ref>
 
Treatment:
*Treat right away with high dose steroids.
**Biopsy is confirmatory.
 
===Microscopic===
Features:
*Artery with intramural inflammatory cells.
**Classically [[granuloma|granulomatous inflammation]].
***Granulomas not required for the diagnosis!
*Destruction of arterial wall, e.g. fibrinoid necrosis (pink anucleate arterial wall).
 
Image(s):
*[http://www.djo.harvard.edu/files/5077_728.jpg GCA (harvard.edu)].
*[http://path.upmc.edu/cases/case646.html GCA - several images (upmc.edu)].
 
===Sign out===
====Negative====
<pre>
TEMPORAL ARTERY, LEFT, BIOPSY:
- MEDIUM SIZE ARTERY WITHOUT PATHOLOGIC DIAGNOSIS, SEE COMMENT.
 
COMMENT:
A negative biopsy does not rule out the possibility of giant cell (temporal)
arteritis, as this may be a focal disorder. The clinical management is
dependent upon the clinical impression.
</pre>


==Takayasu arteritis==
==Takayasu arteritis==
Michael
48,528

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