Vasculitis diagnostic criteria: Difference between revisions

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


==References==
==References==

Latest revision as of 20:45, 31 January 2018