What is vasculitis? Does is mainly affect arteries or veins?
- inflammation of the blood vessel wall
- mainly affects arteries
What are the three broad categories of vasculitis?
- large, medium, and small vessel vasculitis
- (there is considerable overlap)
What are the two main types of large vessel vasculitis?
- temporal (giant cell) arteritis
- Takayasu arteritis
What are the three main types of medium vessel vasculitis?
- polyarteritis nordosa
- Kawasaki disease
- Buerger’s disease
What are the four main types of small vessel vasculitis?
- Wegener granulomatosis
- microscopic polyangiitis
- Churg-Strauss syndrome
- HSP (Henoch-Schonlein purpura)
Temporal (Giant Cell) Arteritis is most common in what demographic? What about Takayasu Arteritis?
- giant cell: female patients > 50
- Takayasu: patients
What type of vasculitis is Temporal (Giant Cell) Arteritis? Which vessels does it commonly affect?
- large vessel vasculitis
- commonly affects the carotid artery
Why do patients with Temporal (Giant Cell) Arteritis commonly present with headaches?
- because the temporal artery branches from the carotid, and the inflammed artery causes pressure in the head
What is a major potential risk of Temporal (Giant Cell) Arteritis?
- blindness due to the proximity of the ophthalmic artery to the carotid
Pathophysiology of Temporal (Giant Cell) Arteritis; What do we see on histology?
- giant cells attack and fragment the internal elastic lamina of the blood vessel wall
- on histology, we would see a huge separation between the intima and media as a result
What type of vasculitis is Takayasu Arteritis? Which vessels does it commonly affect?
- large vessel vasculitis
- commonly affects the aortic arch at its branch points
Pathophysiology of Takayasu Arteritis
- essentially the same as temporal arteritis
- giant cells attack and fragment the internal elastic lamina of the blood vessel wall
Medium vessel vasculitis involves which vessels?
- muscular arteries that supply organs
Polyarteritis Nordosa
- a necrotizing (fibrinoid necrosis) arteritis that is systemic (affects most organs)
- a medium vessel vasculitis
Polyarteritis Nordosa is most common in which demographic?
- young adults
What type of inflammation is involved in Temporal Arteritis and Takayasu Arteritis?
- granulomatous inflammation (hence the giant cells)
What type of necrosis is involved in Polyarteritis Nordosa?
- fibrinoid necrosis
Although it is systemic, which organs are NOT affected by Polyarteritis Nordosa?
- the lungs
What do we see on histology of Polyarteritis Nordosa?
- a ‘string-of-pearls’ appearance
What type of vasculitis is Kawasaki Disease? Which vessels does it usually affect?
- medium vessel vasculitis
- affects the coronary artery
Kawasaki Disease is most common in which demographic?
- asian children
Kawasaki disease commonly affects the coronary artery, greatly increasing the risk of ___________, despite the patient’s young age. Therefore, we commonly give these patients prophylactic ________.
- increased of MI
- give them aspirin!
What type of vasculitis is Buerger’s Disease? Which vessels does it affect?
- a necrotizing medium vessel vasculitis
- affects the arteries in the digits
Buerger’s Disease is only seen in which demographic?
- smokers!
- it is totally associated with smoking
