Vasculitis

Question 1

Classification of vasculitis

Answer 1

inflammation of blood vessel wall

1. Infectious Vasculitis
2. Non-infectious Vasculitis

Question 2

Features of infectious vasculitis

Answer 2

• caused by direct invasion of vascular wall by infectious pathogens
• fungal eg aspergillus, bacterial infections causing septicaemia, emoblisation of IE

Question 3

Immune-mediated mechanisms of non-infectious vasculitis (3)

Answer 3

1. Immune complex deposition - type III hypersensitivity
   - systemic immunological diseases
   - drug hypersensitivity
   - viral infections
2. Anti-neutrophilic cytoplasmic antibodies (ANCA)
   - ANCA activated neutrophils degranulate - release ROS
   - MPO-ANCA
   - PR3-ANCA
3. Anti-endothelial cell antibodies - type II hypersensitivity

Question 4

Specific non-infectious vasculitis conditions

Answer 4

1. Small vessel vasculitis
   - ANCA positive - Wegener’s granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome, drug-induced vasculitis
   - ANCA negative - Henoch-Schonlein purpura, cryoglobulinemic vasculitis, drug-related hypersensitivity, connective tissue disease related, infection induced
2. Medium vessel vasculitis
   - polyarteriitis nodosa, Kawasaki disease
3. Large vessel vasculitis
   - Takayasu disease, giant cell arteritis

Question 5

Effects of vasculitis (2)

Answer 5

1. Thrombosis

2. Haemorrhage

Question 6

Features of cardiovascular syphilis

Answer 6

• tertiary syphilis, often affects root of aorta
• causes vasculitis affecting vasa vasorum, obliterating them
• lesions: aortitis - scarring, coronary ostial occlusion, aneurysm of thoracic aorta, aortic incompetence