Vasculitis

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• very rare in real life

• organ specific symptoms because vessel lumen occludes

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• increase blood flow or hyperemia: blanch when pressed

• see palpable purpura = vasculitis

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Large Vessel

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Temporal Arteritis

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• face and head symptoms

• ophthalmic artery from internal carotid

• High ESR: classic

• granuloma

• high IL6

Takayasu

[_](takayasu's arteritis aka, cause, demographics, symptoms, classic imaging)..

• 30 yrs old age of onset

• picture: narrowing of left subclavian artery

• weak upper extremity pulse

• cold/numb fingers

• granuloma on histology

Medium Vessel

Kawasaki

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• right: aneurysm

• acute: 1st 2 weeks, fever, arthritis, myocarditis, rash

• subacute: skin falls off, aneurysm

Scarlet

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• scarlet fever: sore throat

Reye

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Buerger

[_](buerger's disease aka, demographics, cause, symptoms, treatment)..

• aka thromboangiitis obliterans

• male smokers. Almost never in nonsmokers

• segmental thrombosing vasculitis: blood clots cut off blood to hands/feet

• distal claudication and ulcers

• characterized histologically by intraluminal thrombus and prominent inflammatory cell infiltrate with relative sparing of the vessel wall.

PAN

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• deposit in many places, wide variety of symptoms

• transmural

• ischemia and renal failure

Small vessels

HS purpura

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• complement activated via alternative/lectin pathway. IgA does not fix complement

• biopsy shows IgA deposition

ANCA

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• pulmonary different for each; renal similar for all 3

• lower right: negative IF, no Ig

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Churg Strauss

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• looks like asthma as adule first time refractory to medical therapy

• classic case: adult onset asthma with palpable purpura, eosinophila, p-ANCA

Wegener

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• saddle nose due to ulcers

Microscopic polyangitis

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Goodpasture

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• positive Ig stain

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