Large-sized vessel vasculitis with weight loss: Difference between revisions

Revision as of 16:07, 9 April 2018

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.

			Symptoms					Physical examination			Lab Findings				Imaging				Histopathology
Diseases			Clinical manifestations								Para-clinical findings									Gold standard	Additional findings
			Symptoms					Physical examination			Para-clinical findings
			Headache	Fever	Weight loss	Arthralgia	Claudication	Bruit	HTN	Focal neurological disorder	Biomarker	CBC	ESR	Other	CT scan	Angiography	Ultrasound/ Echocardiography	Other	Histopathology
Large-Vessel Vasculitis	Takayasu arteritis^[1]		+	+/-	+	-	+	+	+/-	+/-	MMP-3 and MMP-9	Leukocytosis, Anemia	↑	↑CRP	Aneurysmal dilatation of the aorta	Blood vessel stenosis	Circumferential thickening of the arterial wall (Macaroni sign)	PET-scan, Cardiac CT	Granulomatous inflammation of arteries	Arteriography	Coronary aneurysm
	Giant cell arteritis^[2]		+	-	+	+/-	-	-	-	+/-	Pentraxin 3 (PTX3)	Normal	↑	↑CRP	Stenosis, Occlusion, Dilatation	Aneurysm	-	Mural inflammation in MRA	Granulomatous inflammation of arteries	Biopsy	Jaw pain and claudication
	Neurological disease	Neurofibromatosis type 1^[3]	+/-	-	+/-	-	-	-	+	+	NF1 mutated gene	Normal	Normal	Neurofibromin gene	Bone abnormalities	Optical coherence tomography angiography (OCTA)	-	Optic nerve gliomas in MRI	Elongated spindle-shaped cells in neurofibromas	NIH diagnostic criteria	Cafe au Lait spot
	Neurological disease	Neurofibromatosis type 2^[4]	+/-	-	+/-	-	+/-	-	-	+	NF2 mutated gene	Normal	Normal	Schwannomin	Meningioma, Schwannoma, Ependymoma	Fluorescein angiography showed retinal hamartoma	Localized schwannomas in nerve ultrasound	Schwannoma in MRI	Encapsulated biphasic nerve sheath tumor	NIH diagnostic criteria	Hearing loss, Vision loss
	Systemic disease	Fibromuscular dysplasia^[5]	+	-	+/-	+	+	+	+	+/-	Transforming growth factor β (TGF-β)	Normal	↑	↑ Cr or BUN	Alternating stenosis and dilatations in CT angiography	Stenosis in the renal arteries	Luminal narrowing alternating with dilatation (Beads sign)	Focal concentric, long-segment tubular stenosis or outpouching in MRA	Fibrodysplastic changes, Collagen deposition	Digital subtraction angiography (DSA)	Spontaneous coronary artery dissection (SCAD)
	Systemic disease	Polymyalgia rheumatica (PMR)^[6]	+	-	+/-	+	-	-	-	-	Plasma fibrinogen	Normocytic, normochromic anemia	↑	CRP	Periodontoid localization of calcification	Vessel wall thickening, Increased mural contrast enhancement	Subacromial or subdeltoid bursitis	High F-FDG accumulation around the joints in FDG PET-CT	Small angular fibers, Pyknotic nuclear clumps, or target-targetoid fibers	-	Joint stiffness, Fatigue

References

↑ Vaideeswar P, Deshpande JR (2013). "Pathology of Takayasu arteritis: A brief review". Ann Pediatr Cardiol. 6 (1): 52–8. doi:10.4103/0974-2069.107235. PMC 3634248. PMID 23626437.
↑ Calvo-Romero JM (2003). "Giant cell arteritis". Postgrad Med J. 79 (935): 511–5. PMC 1742823. PMID 13679546.
↑ Cassiman C, Casteels I, Stalmans P, Legius E, Jacob J (2017). "Optical Coherence Tomography Angiography of Retinal Microvascular Changes Overlying Choroidal Nodules in Neurofibromatosis Type 1". Case Rep Ophthalmol. 8 (1): 214–220. doi:10.1159/000469702. PMC 5422752. PMID 28512424.
↑ Evans, D G. R (2000). "Neurofibromatosis type 2". Journal of Medical Genetics. 37 (12): 897–904. doi:10.1136/jmg.37.12.897. ISSN 1468-6244.
↑ Plouin PF, Perdu J, La Batide-Alanore A, Boutouyrie P, Gimenez-Roqueplo AP, Jeunemaitre X (2007). "Fibromuscular dysplasia". Orphanet J Rare Dis. 2: 28. doi:10.1186/1750-1172-2-28. PMC 1899482. PMID 17555581.
↑ Michet CJ, Matteson EL (2008). "Polymyalgia rheumatica". BMJ. 336 (7647): 765–9. doi:10.1136/bmj.39514.653588.80. PMC 2287267. PMID 18390527.

Template:WH Template:WS

[pmid23626437-1] Vaideeswar P, Deshpande JR (2013). "Pathology of Takayasu arteritis: A brief review". Ann Pediatr Cardiol. 6 (1): 52–8. doi:10.4103/0974-2069.107235. PMC 3634248. PMID 23626437.

[pmid13679546-2] Calvo-Romero JM (2003). "Giant cell arteritis". Postgrad Med J. 79 (935): 511–5. PMC 1742823. PMID 13679546.

[pmid28512424-3] Cassiman C, Casteels I, Stalmans P, Legius E, Jacob J (2017). "Optical Coherence Tomography Angiography of Retinal Microvascular Changes Overlying Choroidal Nodules in Neurofibromatosis Type 1". Case Rep Ophthalmol. 8 (1): 214–220. doi:10.1159/000469702. PMC 5422752. PMID 28512424.

[Evans2000-4] Evans, D G. R (2000). "Neurofibromatosis type 2". Journal of Medical Genetics. 37 (12): 897–904. doi:10.1136/jmg.37.12.897. ISSN 1468-6244.

[pmid17555581-5] Plouin PF, Perdu J, La Batide-Alanore A, Boutouyrie P, Gimenez-Roqueplo AP, Jeunemaitre X (2007). "Fibromuscular dysplasia". Orphanet J Rare Dis. 2: 28. doi:10.1186/1750-1172-2-28. PMC 1899482. PMID 17555581.

[pmid18390527-6] Michet CJ, Matteson EL (2008). "Polymyalgia rheumatica". BMJ. 336 (7647): 765–9. doi:10.1136/bmj.39514.653588.80. PMC 2287267. PMID 18390527.

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@@ Line 5: / Line 5: @@
 <span style="font-size:85%">'''Abbreviations:'''
 ABG= [[Arterial blood gas]], ANA= [[Antinuclear antibody]], ANP= [[Atrial natriuretic peptide]], ASO= [[Antistreptolysin O|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]].</span>
+<small>
 {| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
 ! colspan="3" rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Diseases
@@ Line 36: / Line 37: @@
 ! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
 |-
-! rowspan="9" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Large-Vessel Vasculitis
+! rowspan="6" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Large-Vessel Vasculitis
 ! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Takayasu arteritis]]<ref name="pmid23626437">{{cite journal| author=Vaideeswar P, Deshpande JR| title=Pathology of Takayasu arteritis: A brief review. | journal=Ann Pediatr Cardiol | year= 2013 | volume= 6 | issue= 1 | pages= 52-8 | pmid=23626437 | doi=10.4103/0974-2069.107235 | pmc=3634248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23626437  }}</ref>
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
@@ Line 79: / Line 80: @@
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Jaw pain]] and [[Jaw claudication|claudication]]
 |-
-! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Neurological disease]]
+! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Neurological disease]]
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cerebral aneurysm]]<ref name="pmid20557771">{{cite journal| author=Stafa A, Leonardi M| title=Role of neuroradiology in evaluating cerebral aneurysms. | journal=Interv Neuroradiol | year= 2008 | volume= 14 Suppl 1 | issue=  | pages= 23-37 | pmid=20557771 | doi=10.1177/15910199080140S106 | pmc=3328052 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20557771  }}</ref>
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Well-defined round, slightly hyperattenuating lesion
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Bulging out of the [[Lumen|main lumen]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Heterogeneous]] signal intensity in [[Magnetic resonance angiography|MRA]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Layers of [[smooth muscle cells]], Intact [[endothelium]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Digital subtraction angiography|Digital subtraction angiography (DSA)]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Nausea]], [[Vomiting]]
-|-
 ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Neurofibromatosis type 1]]<ref name="pmid28512424">{{cite journal| author=Cassiman C, Casteels I, Stalmans P, Legius E, Jacob J| title=Optical Coherence Tomography Angiography of Retinal Microvascular Changes Overlying Choroidal Nodules in Neurofibromatosis Type 1. | journal=Case Rep Ophthalmol | year= 2017 | volume= 8 | issue= 1 | pages= 214-220 | pmid=28512424 | doi=10.1159/000469702 | pmc=5422752 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28512424  }}</ref>
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/-
@@ Line 143: / Line 123: @@
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hearing loss]], [[Vision loss]]
 |-
-! rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Systemic disease]]
+! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Systemic disease]]
 ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Fibromuscular dysplasia]]<ref name="pmid17555581">{{cite journal| author=Plouin PF, Perdu J, La Batide-Alanore A, Boutouyrie P, Gimenez-Roqueplo AP, Jeunemaitre X| title=Fibromuscular dysplasia. | journal=Orphanet J Rare Dis | year= 2007 | volume= 2 | issue=  | pages= 28 | pmid=17555581 | doi=10.1186/1750-1172-2-28 | pmc=1899482 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17555581  }}</ref>
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
@@ Line 164: / Line 144: @@
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Digital subtraction angiography|Digital subtraction angiography (DSA)]]
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Spontaneous coronary artery dissection|Spontaneous coronary artery dissection (SCAD)]]
-|-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ehlers-Danlos syndrome]]<ref name="pmid27824552">{{cite journal| author=Gazit Y, Jacob G, Grahame R| title=Ehlers-Danlos Syndrome-Hypermobility Type: A Much Neglected Multisystemic Disorder. | journal=Rambam Maimonides Med J | year= 2016 | volume= 7 | issue= 4 | pages=  | pmid=27824552 | doi=10.5041/RMMJ.10261 | pmc=5101008 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27824552  }}</ref>
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[TGF-β]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Cultured skin [[fibroblasts]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Multiple [[vascular]] segments with [[aneurysms]] and [[dissections]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Dissection]] of the [[Circumflex branch of left coronary artery|posterolateral branch of the left circumflex coronary artery (LCx)]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Visceral]] [[arteries]] abnormality
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Vascular anomaly|Vascular abnormalities]] in [[MRA]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Thin and rare [[collagen]] bundles in the [[dermis]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |History and [[physical examination]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Bleeding]], [[Easy bruising|Bruisability]], [[Heart murmur]]
 |-
 ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Polymyalgia rheumatica|Polymyalgia rheumatica (PMR)]]<ref name="pmid18390527">{{cite journal| author=Michet CJ, Matteson EL| title=Polymyalgia rheumatica. | journal=BMJ | year= 2008 | volume= 336 | issue= 7647 | pages= 765-9 | pmid=18390527 | doi=10.1136/bmj.39514.653588.80 | pmc=2287267 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18390527  }}</ref>
@@ Line 206: / Line 165: @@
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Joint stiffness]], [[Fatigue]]
-|-
-! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Amyloidosis]]<ref name="pmid23227278">{{cite journal| author=Baker KR, Rice L| title=The amyloidoses: clinical features, diagnosis and treatment. | journal=Methodist Debakey Cardiovasc J | year= 2012 | volume= 8 | issue= 3 | pages= 3-7 | pmid=23227278 | doi= | pmc=3487569 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23227278  }}</ref>
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Immunoglobulin light chains|Immunoglobulin light chain]][[Amyloid beta|(Amyloid)]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Anemia]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑ [[Creatinine|Cr]] or [[Blood urea nitrogen|BUN]],
-↑ [[ALT]] or [[AST]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffusely hypoattenuating and enlarged [[liver]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Amyloid]] deposition in the media and [[adventitia]] of small arteries
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Solid organs increased [[echogenicity]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Tc-DPD for [[cardiac]] '''[[amyloid]]''' deposits
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Extracellular]] deposition of [[Fibrillarin|fibrillar proteins]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Biopsy]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Cardiomegaly]], [[Dyspnea]]
 |-
 |}
+</small>
 ==References==

Large-sized vessel vasculitis with weight loss: Difference between revisions

Revision as of 16:07, 9 April 2018

References

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