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| {{Vasculitis}} | | {{Vasculitis}} |
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| {{CMG}}; '''Associate Editor-In-Chief:''' {{MUT}} | | {{CMG}}; {{AE}} {{MUT}} |
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| ==Overview== | | ==Overview== |
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| ==Diagnostic Criteria== | | ==Diagnostic Criteria== |
| ===[[Takayasu arteritis]]===
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| At least 3 out of 6 criteria yields sensitivity and specificity of 90.5 and 97.8%:
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| * Onset < 40 years
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| * [[Claudication]] of extremities
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| * Decreased pulsation of one or both [[brachial|brachial arteries]]
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| * At least 10 mmHg [[cardiac cycle|systolic]] difference in both arms
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| * [[Bruit]] over one or both [[carotid arteries]] or abdominal aorta
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| * Arteriographic narrowing of [[aorta]], its primary branches, or large arteries in upper or lower extremities
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| ===[[Temporal arteritis|Giant cell (temporal) arteritis]]===
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| At least 3 out of 5 criteria yields sensitivity and specificity of 95 and 91%:
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| * Age at onset ≥ 50 years
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| * New onset [[headache]] with localized tenderness
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| * [[Temporal artery]] tenderness or decreased pulsation
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| * Elevated [[ESR]] ≥ 50 mm/hour Westergren
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| * Temporal artery biopsy showing vasculitis with [[mononuclear cell]] infiltrate or granulomatous inflammation, usually with multinucleated giant cells
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| ===[[Polyarteritis nodosa]]===
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| At least 3 out of 10 criteria yields sensitivity and specificity of 82 and 87%:
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| * Unexplained [[weight loss]] > 4 kg
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| * [[Livedo reticularis]]
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| * [[Testicular pain]]
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| * [[Myalgias]], [[weakness]]
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| * [[Mononeuropathy]] or [[polyneuropathy]]
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| * New onset diastolic blood pressure > 90 mmHg
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| * Elevated serum [[BUN]] (> 40 mg/dL) or serum [[creatinine]] (> 1.5 mg/dL)
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| * [[Hepatitis B infection]]
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| * Arteriographic abnormalities
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| * Arterial biopsy showing [[polymorphonuclear cells]]
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| ===[[Wegener's granulomatosis]]===
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| At least 2 out of 4 criteria yields sensitivity and specificity of 88 and 92%.
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| * Nasal or oral inflammation (oral ulcers or purulent/bloody nasal discharge, may be painful)
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| * Abnormal CXR showing nodules, infiltrates, cavities
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| * Microscopic hematuria or RBC casts
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| * Vessel biopsy shows granulomatous inflammation
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| ===[[Kawasaki disease]]===
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| Diagnosis requires fever lasting five days or more with at least 4 out of 5 criteria:
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| * Bilateral conjunctival injection
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| * Injected or fissured lips, injected pharynx, or strawberry tongue
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| * Erythema of palms/soles, edema of hands/feet, periungual desquamation
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| * Polymorphous rash
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| * Cervical lymphadenopathy (at least one node > 1.5 cm)
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| ===Isolated CNS vasculitis===
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| Patients have CNS symptoms as well as cerebral vasculitis by angiography and leptomeningeal biopsy.
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| ===[[Churg-Strauss syndrome|Churg-Strauss arteritis]]===
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| At least 4 criteria yields sensitivity and specificity of 85 and 99.7%.
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| * [[Asthma]] (history of [[wheezing]] or presently wheezing)
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| * [[Eosinophilia]] > 10% on CBC
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| * [[Mononeuropathy]] or [[polyneuropathy]]
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| * Migratory or transient pulmonary opacities on [[CXR]]
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| * [[Paranasal sinus]] abnormalities
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| * Vessel biopsy showing eosinophils in extravascular areas
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| ===[[Hypersensitivity vasculitis]]===
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| At least 3 out of 5 criteria yields sensitivity and specificity of 71 and 84%:
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| * Age > 16
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| * Use of possible triggering drug in relation to symptoms
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| * Palpable [[purpura]]
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| * Maculopapular rash
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| * Skin biopsy showing [[neutrophils]] around vessel
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| ===[[Henoch-Schonlein purpura]]===
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| Presence of 3 or more criteria yielded sensitivity of 87% while less than 2 criteria yielded hypersensitivity vasculitis in 74%:
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| * Palpable [[purpura]] (usually of buttocks & legs)
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| * [[Mesenteric ischemia]]
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| * [[GI bleed]]
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| * [[Hematuria]]
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| * Onset < 20 years
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| * No new medications
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| ==References== | | ==References== |