Single organ vasculitis

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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.

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging Histopathology
Headache Fever Weight loss Arthralgia Claudication Bruit HTN Focal neurological disorder Biomarker CBC ESR Other CT scan Angiography Ultrasound/ Echocardiography Other
Single-organ vasculitis Primary central nervous system vasculitis[1] + + + - + - + + von Willebrand factor antigen (vWF) Normal - CSF pleocytosis, predominantly lymphocytes Cerebral infarcts or hemorrhages with mass effect, or hydrocephalus Aneurysm in circle of Willis - Progression of the disease or response to therapy in MRI Chronic granulomatous inflammation and giant cells Histological confirmation Skin rash, Purpura
Infectious disease Aspergillosis[2] + + + - - - - + Aspergillus nucleic acid in blood, Galactomannan Eosinophilia ↑Serum IgE Aspergilloma mass within a cavity Mass effect stenosis - Aspergilloma mass within the brain in MRI Septate hyphae, branching at acute angles, and tissue necrosis with granulomata and blood vessel invasion Histological confirmation Hemoptysis, Aspergilloma
Histoplasmosis[3] + + + + + - - + - Mild anemia ALP, ↑LDH Cerebral histoplasmosis  - Valvular involvement in echocardiography PFT Presence of yeast forms in tissue through hematoxylin and eosin staining Sputum cultures Pneumonia, Mediastinitis
Herpes Simplex Encephalitis[4] + + - - - - - + HSV DNA Mild lymphocytosis CSF pleocytosis Low-density lesions in the temporal and/or frontal lobe - - Hemorrhagic lesion in white matter Multinuclear giant cells PCR or brain biopsy Seizures,

Vomiting

Systemic disease Eclampsia[5] + + - + - - + + VEGF, PlGF, Soluble FLT-1 AnemiaThrombocytopenia, Schistocytes - Bilirubin, ↓Haptoglobin, ↑LDH, ↑Cr Cortical hypodense areas in the occipital lobes, Diffuse cerebral edema - Poor fetal growth, Oligohydramnios, Abnormal umbilical artery  Increased signal at the gray-white matter junction in MRI - 24-hour urine study  Seizure, Edema
Fibromuscular dysplasia[6] + - +/- + + + + +/- 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)

References

  1. Benseler SM, Silverman E, Aviv RI, Schneider R, Armstrong D, Tyrrell PN, deVeber G (April 2006). "Primary central nervous system vasculitis in children". Arthritis Rheum. 54 (4): 1291–7. doi:10.1002/art.21766. PMID 16575852.
  2. Latgé JP (1999). "Aspergillus fumigatus and aspergillosis". Clin Microbiol Rev. 12 (2): 310–50. PMC 88920. PMID 10194462.
  3. Guimarães AJ, Nosanchuk JD, Zancopé-Oliveira RM (2006). "DIAGNOSIS OF HISTOPLASMOSIS". Braz J Microbiol. 37 (1): 1–13. doi:10.1590/S1517-83822006000100001. PMC 2863343. PMID 20445761.
  4. Sköldenberg B (1996). "Herpes simplex encephalitis". Scand J Infect Dis Suppl. 100: 8–13. PMID 9163027.
  5. Uzan J, Carbonnel M, Piconne O, Asmar R, Ayoubi JM (2011). "Pre-eclampsia: pathophysiology, diagnosis, and management". Vasc Health Risk Manag. 7: 467–74. doi:10.2147/VHRM.S20181. PMC 3148420. PMID 21822394.
  6. 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.

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