Differentiating Polyarteritis nodosa from other diseases: Difference between revisions

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__NOTOC__
__NOTOC__
{{Polyarteritis nodosa}}
{{Polyarteritis nodosa}}
{{CMG}}; {{AE}} {{CZ}}; [[User:Haritha|Haritha Machavarapu, M.B.B.S.]]
{{CMG}}; {{AE}} {{EG}}


==Overview==
==Overview==
Polyarteritis nodosa must be differentiated from other diseases that cause may lead to medium vessel [[vasculitis]]. The diseases that can lead to medium vessel [[vasculitis]] are polyarteritis nodosa, [[kawasaki disease]], infections, cardiovascular diseases and systemic diseases.


==Differentiating Polyarteritis Nodosa from other Diseases==
==Differentiating Polyarteritis Nodosa from other Diseases==
*[[Microscopic polyangitis]] has clinical manifestations similar to [[PAN]], but is characterized by presence of [[rapidly progressive glomerulonephritis]] and lung involvement unlike PAN.<ref name="pmid9643314">{{cite journal |author=Lhote F, Cohen P, Guillevin L |title=Polyarteritis nodosa, microscopic polyangiitis and Churg-Strauss syndrome |journal=Lupus |volume=7 |issue=4 |pages=238–58 |year=1998 |pmid=9643314 |doi= |url=}}</ref>
* The following table differentiates polyarteritis nodosa from other diseases that may lead to medium vessel vasculitis.
*[[Churg Strauss disease]] is characterized by hypereosinophilia and vasculitis like [[PAN]] in individuals with asthma and allergic nephritis.
<span style="font-size:85%">'''Abbreviations:'''
*[[Henoch Schonlein purpura]]
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>
*Vasculitis secondary to connective tissue disorder
<small>
*[[Cryoglobulinemic vasculitis]]
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
*[[Wegner's Granulomatosis]]
! colspan="2" rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Diseases
*[[Giantcell arteritis]]
| colspan="8" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Clinical manifestations'''
*[[Infective endocarditis]]
! colspan="9" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Para-clinical findings
*[[Mycotic aneurysm]]
| colspan="1" rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Gold standard'''
*[[Atherosclerosis]]
! rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Additional findings
|-
| colspan="5" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Symptoms'''
! colspan="3" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" | Physical examination
|-
! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings
! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Histopathology
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Headache
! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Fever
! style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
! style="background:#4479BA; color: #FFFFFF;" align="center" |Arthralgia
! style="background:#4479BA; color: #FFFFFF;" align="center" |Claudication
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bruit
! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |HTN
! style="background:#4479BA; color: #FFFFFF;" align="center" |Focal neurological disorder
! style="background:#4479BA; color: #FFFFFF;" align="center" |Biomarker
! style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |ESR
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |CT scan
! style="background:#4479BA; color: #FFFFFF;" align="center" |Angiography
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ultrasound/ Echocardiography
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
|-
! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Polyarteritis nodosa]]<ref name="pmid25770638">{{cite journal| author=Howard T, Ahmad K, Swanson JA, Misra S| title=Polyarteritis nodosa. | journal=Tech Vasc Interv Radiol | year= 2014 | volume= 17 | issue= 4 | pages= 247-51 | pmid=25770638 | doi=10.1053/j.tvir.2014.11.005 | pmc=4363102 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25770638  }}</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" |[[LAMP2|LAMP-2 protein autoantibodies]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]], [[Normochromic anemia]], [[Thrombocytosis]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑ [[Creatinine|Cr]] or [[Blood urea nitrogen|BUN]],
↑ [[ALT]] or [[AST]], [[Proteinuria]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Focal regions of [[infarction]] or [[hemorrhage]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Multiple [[Aneurysm|microaneurysms]],  [[Hemorrhage]] due to focal [[rupture]], [[Occlusion]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Aneurysms]] and [[renal]] [[arteriovenous fistula]] in [[Doppler sonography|color Doppler sonography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Necrotizing]] [[inflammatory]] lesions
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Angiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Sudden [[weight loss]], [[Abdominal pain]]
|-
! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis B virus]]-associated [[polyarteritis nodosa]]<ref name="pmid25755502">{{cite journal |vauthors=Sharma A, Sharma K |title=Hepatotropic viral infection associated systemic vasculitides-hepatitis B virus associated polyarteritis nodosa and hepatitis C virus associated cryoglobulinemic vasculitis |journal=J Clin Exp Hepatol |volume=3 |issue=3 |pages=204–12 |date=September 2013 |pmid=25755502 |pmc=4216827 |doi=10.1016/j.jceh.2013.06.001 |url=}}</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" |[[Hepatitis B surface antigen|HBsAg]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]], [[Normochromic anemia]], [[Thrombocytosis]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑ [[ALT]] or [[AST]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Focal regions of [[infarction]] or [[hemorrhage]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Aneurysms|Microaneurysms]] in [[mesenteric artery]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Aneurysms]] and [[renal]] [[arteriovenous fistula]] in [[Doppler sonography|color Doppler sonography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Necrotizing]] [[inflammatory]] lesions
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Angiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Peripheral neuropathy]], [[Livedo reticularis]]
|-
! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Kawasaki disease]]<ref name="pmid21447126">{{cite journal| author=Takahashi K, Oharaseki T, Yokouchi Y| title=Pathogenesis of Kawasaki disease. | journal=Clin Exp Immunol | year= 2011 | volume= 164 Suppl 1 | issue=  | pages= 20-2 | pmid=21447126 | doi=10.1111/j.1365-2249.2011.04361.x | pmc=3095860 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21447126  }}</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" |[[NT-proBNP]], [[Meprin A]], [[Filamin A interacting protein 1 like|Filamin C]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Normochromic anemia]], ↑[[WBC]] with a [[left shift]], [[Thrombocytosis]] 
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Acute phase reactant|Acute-phase reactants]], ↓[[Cholesterol]], ↓[[HDL]], ↓[[Apolipoprotein A1|ApolipoA]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Coronary artery]] [[Calcification|calcifications]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Coronary artery aneurysm|Coronary artery aneurysms]], [[Coronary artery stenosis|stenosis]] or [[Coronary artery anomaly|occlusion]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Coronary artery anomaly]] in [[echocardiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Electron beam tomography|Electron beam CT (EBCT)]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Acute destruction of the [[Tunica media|media]] by [[neutrophils]], with loss of [[elastic fibers]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |History and [[physical examination]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Diarrhea]], [[Vomiting]]
|-
! rowspan="10" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Infectious disease]]
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Parvovirus B19 infection]]<ref name="pmid12097253">{{cite journal| author=Heegaard ED, Brown KE| title=Human parvovirus B19. | journal=Clin Microbiol Rev | year= 2002 | volume= 15 | issue= 3 | pages= 485-505 | pmid=12097253 | doi= | pmc=118081 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12097253  }}</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" |[[Parvovirus B19|B19]] [[DNA]], ↓[[Reticulocyte count]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Anemia]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |anti–[[parvovirus B19]] [[IgM]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hydrops]] in fetal [[ultrasonography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Parvovirus B19|B19]] [[DNA]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Purpura|Purpuric rash]], [[Erythema multiforme]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Scarlet fever]]<ref name="pmid29081840">{{cite journal| author=Basetti S, Hodgson J, Rawson TM, Majeed A| title=Scarlet fever: a guide for general practitioners. | journal=London J Prim Care (Abingdon) | year= 2017 | volume= 9 | issue= 5 | pages= 77-79 | pmid=29081840 | doi=10.1080/17571472.2017.1365677 | pmc=5649319 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29081840  }}</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" |[[Antistreptococcal antibodies|Antistreptolysin-O (ASO) titers]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑[[CRP]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Thickened [[pulmonary]] markings if [[pneumonia]]
! 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" |Sparse [[Neutropenia|neutrophilic]] [[Perivascular cell|perivascular infiltrate]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |History and [[physical examination]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Sand-paper rashes, [[Sore throat]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Toxic shock syndrome]]<ref name="pmid22180682">{{cite journal| author=Vostral SL| title=Rely and Toxic Shock Syndrome: a technological health crisis. | journal=Yale J Biol Med | year= 2011 | volume= 84 | issue= 4 | pages= 447-59 | pmid=22180682 | doi= | pmc=3238331 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22180682  }}</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" |[[Procalcitonin]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]] with [[left shift]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Myoglobinuria]], [[Pyuria|Sterile pyuria]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Acute respiratory distress syndrome]]
! 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" |[[Necrosis|Necrolysis]] of [[keratinocytes]] in [[epidermis]],  Perivascular [[lymphocytic]] infiltrate
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Clinical criteria
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Peeling or [[rashes]], Organ dysfunction
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Mononucleosis]]<ref name="pmid25774295">{{cite journal| author=Balfour HH, Dunmire SK, Hogquist KA| title=Infectious mononucleosis. | journal=Clin Transl Immunology | year= 2015 | volume= 4 | issue= 2 | pages= e33 | pmid=25774295 | doi=10.1038/cti.2015.1 | pmc=4346501 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25774295  }}</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" |[[Epstein Barr virus|EBV]] [[DNA]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Atypical lymphocyte]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Heterophile antibody test|Heterophile antibodies]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[CNS Disease|CNS involvement]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Splenomegaly]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Encephalitis]] in [[MRI]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Lymphoproliferative response]] in [[oropharynx]], [[Lymphocytic|Lymphocytic infiltration]] in [[spleen]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Heterophile antibody test]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Splenomegaly]], [[Palatal]] [[petechiae]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Leptospirosis]]<ref name="pmid11292640">{{cite journal |vauthors=Levett PN |title=Leptospirosis |journal=Clin. Microbiol. Rev. |volume=14 |issue=2 |pages=296–326 |date=April 2001 |pmid=11292640 |pmc=88975 |doi=10.1128/CMR.14.2.296-326.2001 |url=}}</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" |[[Interleukin 6|IL-6]], [[IL-8]] and [[IL-10]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Anemia]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑[[Creatinine|Cr]] or [[Blood urea nitrogen|BUN]],
↑[[ALT]] or [[AST]], [[Proteinuria]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" | Diffuse [[alveolar]] [[hemorrhage]]
! 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" |[[Toxin]]-mediated break down of [[endothelial cell]] membranes of [[capillaries]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Culture and the [[Agglutination|microscopic agglutination test]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Red eyes]], [[Skin rash]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Lyme disease|Lyme Disease]]<ref name="pmid23319969">{{cite journal| author=Biesiada G, Czepiel J, Leśniak MR, Garlicki A, Mach T| title=Lyme disease: review. | journal=Arch Med Sci | year= 2012 | volume= 8 | issue= 6 | pages= 978-82 | pmid=23319969 | doi=10.5114/aoms.2012.30948 | pmc=3542482 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23319969  }}</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" |[[CXCL9|CXCL9 (MIG)]], [[CXCL10|CXCL10 (IP-10)]] and [[CCL19|CCL19 (MIP3B)]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukopenia]], [[Thrombocytopenia]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Microscopic hematuria]], [[Proteinuria]], ↑[[ALT]] or [[AST]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Punctate lesions in periventricular [[white matter]] in [[brain]] [[SPECT]]
! 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" |[[Acrodermatitis chronica atrophicans]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Serological testing|Serologic '''tests''']]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Erythema migrans]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Measles]]<ref name="pmid22510638">{{cite journal| author=White SJ, Boldt KL, Holditch SJ, Poland GA, Jacobson RM| title=Measles, mumps, and rubella. | journal=Clin Obstet Gynecol | year= 2012 | volume= 55 | issue= 2 | pages= 550-9 | pmid=22510638 | doi=10.1097/GRF.0b013e31824df256 | pmc=3334858 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22510638  }}</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" |[[Measles]] [[Immunoglobulin M|IgM]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukopenia]], [[Lymphocytosis]], [[Thrombocytopenia]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑[[ALT]] or [[AST]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Pneumonia]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Chest X-ray|CXR]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Spongiosis and vesiculation in the [[epidermis]] with scattered dyskeratotic [[keratinocytes]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[PCR]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Rash|Generalized rash]], [[Cough]], [[Coryza]], or [[Conjunctivitis]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Rocky Mountain Spotted Fever]]<ref name="pmid2504480">{{cite journal| author=Walker DH| title=Rocky Mountain spotted fever: a disease in need of microbiological concern. | journal=Clin Microbiol Rev | year= 1989 | volume= 2 | issue= 3 | pages= 227-40 | pmid=2504480 | doi= | pmc=358117 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2504480  }}</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" |''[[Rickettsia rickettsii infection|R rickettsii]]'' [[serology]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Thrombocytopenia]], [[Anemia]] 
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑[[ALT]] or [[AST]], [[Hyponatremia]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Infarction]], [[edema]], and [[meningeal]] enhancement
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Myocardial]] or conduction abnormalities in [[echocardiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Immunofluorescent]] or [[immunoperoxidase]] staining of ''[[Rickettsia rickettsii infection|R rickettsii]]''
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Clinical criteria and [[tick]] exposure
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Rash on the [[Palms of the hands|palms]] and [[soles]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Staphylococcal scalded skin syndrome|Staphylococcal Scalded Skin Syndrome]]<ref name="pmid27651848">{{cite journal| author=Mishra AK, Yadav P, Mishra A| title=A Systemic Review on Staphylococcal Scalded Skin Syndrome (SSSS): A Rare and Critical Disease of Neonates. | journal=Open Microbiol J | year= 2016 | volume= 10 | issue=  | pages= 150-9 | pmid=27651848 | doi=10.2174/1874285801610010150 | pmc=5012080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27651848  }}</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" |Anti exfoliatin and [[Alpha toxin|anti alpha-toxin antibodies]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]] with [[left shift]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Blood culture]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Pneumonia]]
! 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" |[[Epidermal bullosa simplex|Intraepidermal blister]], dense superficial perivascular lymphohistiocytic infiltrate 
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Blood culture]] and clinical findings
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Erythroderma|'''Widespread''' skin erythema]], [[Blisters|fluid-filled '''blisters''']]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Toxic Epidermal Necrolysis]]<ref name="pmid27239294">{{cite journal| author=Hoetzenecker W, Mehra T, Saulite I, Glatz M, Schmid-Grendelmeier P, Guenova E et al.| title=Toxic epidermal necrolysis. | journal=F1000Res | year= 2016 | volume= 5 | issue=  | pages=  | pmid=27239294 | doi=10.12688/f1000research.7574.1 | pmc=4879934 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27239294  }}</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" |[[MicroRNA|MicroRNA-124]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Normocytic normochromic anemia|Normochromic normocytic anemia]], [[Eosinophilia]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Fluid loss]] and [[electrolyte abnormalities]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tracheobronchial]] [[inflammation]]
! 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" |[[Necrotic]] [[keratinocytes]] with full-thickness [[epithelial]] [[necrosis]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Histopathology]] and clinical findings
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Erythematous rash|Erythematous macular rash]] with [[purpuric]] centers
|-
! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cardiovascular disease]]
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Atrial Myxoma]]<ref name="pmid8407260">{{cite journal |vauthors=MacGowan SW, Sidhu P, Aherne T, Luke D, Wood AE, Neligan MC, McGovern E |title=Atrial myxoma: national incidence, diagnosis and surgical management |journal=Ir J Med Sci |volume=162 |issue=6 |pages=223–6 |date=June 1993 |pmid=8407260 |doi= |url=}}</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" |[[Calretinin]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Mild [[anemia]], [[Leukocytosis]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑[[Interleukin 6|IL-6]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Atrial]] filling defect larger than a [[thrombus]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Tumor]] location, size, attachment, and mobility in [[echocardiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Size, shape, and surface characteristics in [[MRI]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Lipid|Lipidic]] cells embedded in a [[vascular]] myxoid stroma
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Echocardiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Dyspnea on exertion]], [[Syncope]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cholesterol Embolism]]<ref name="pmid21886725">{{cite journal| author=Avci G, Akoz T, Gul AE| title=Cutaneous cholesterol embolization. | journal=J Dermatol Case Rep | year= 2009 | volume= 3 | issue= 2 | pages= 27-9 | pmid=21886725 | doi=10.3315/jdcr.2009.1031 | pmc=3157794 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21886725  }}</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" |[[Interleukin 5|IL-5]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Eosinophilia]], [[Leukocytosis]]  
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Eosinophiluria]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Thoracic aorta|Thoracic]] and [[Abdominal aorta|abdominal aortic]] sources of [[embolism]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Atheroembolism]] in [[abdominal aorta]] and the [[lower extremity]] [[arteries]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Excluding an [[intracardiac]] source of [[embolism]] with [[echocardiography]] 
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Birefringent]] crystals or biconvex needle-shaped ghostly clefts within the [[arterial]] [[lumen]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Angiography]] 
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Livedo reticularis]],


[[Ischemic|Ischemic patches]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Segmental arteries|Segmental arterial]] mediolysis<ref name="Chao2009">{{cite journal|last1=Chao|first1=Christine|title=Segmental Arterial Mediolysis|journal=Seminars in Interventional Radiology|volume=26|issue=03|year=2009|pages=224–232|issn=0739-9529|doi=10.1055/s-0029-1225666}}</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" |[[Leukocytosis]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Visceral]] artery [[aneurysm]] in [[CT angiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Alternating [[aneurysms]] and [[stenoses]] (beading)
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Retroperitoneal hematoma]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Disruption of the [[smooth muscle]] in the [[Tunica media|media]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Angiography]] 
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hematuria]], [[Ischemic colitis]]
|-
! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Systemic disease]]
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Antiphospholipid syndrome|Antiphospholipid Syndrome]]<ref name="pmid26637701">{{cite journal| author=Chaturvedi S, McCrae KR| title=The antiphospholipid syndrome: still an enigma. | journal=Hematology Am Soc Hematol Educ Program | year= 2015 | volume= 2015 | issue=  | pages= 53-60 | pmid=26637701 | doi=10.1182/asheducation-2015.1.53 | pmc=4877624 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26637701  }}</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" |[[Antiphospholipid antibodies]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Thrombocytopenia]], [[Hemolytic anemia]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Lupus anticoagulant|Lupus anticoagulant (LA)]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Stroke]],
[[Pulmonary embolism]], [[Budd-Chiari syndrome]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Thrombus]] in major [[vessels]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Valve thickening, vegetations, or  insufficiency in [[echocardiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Noninflammatory bland [[thrombosis]] without perivascular [[inflammation]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Hx of [[thrombosis]] and [[antiphospholipid antibodies]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Miscarriage]], [[Pulmonary hypertension]]
|-
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Juvenile Idiopathic Arthritis]]<ref name="pmid22753788">{{cite journal |vauthors=Espinosa M, Gottlieb BS |title=Juvenile idiopathic arthritis |journal=Pediatr Rev |volume=33 |issue=7 |pages=303–13 |date=July 2012 |pmid=22753788 |doi=10.1542/pir.33-7-303 |url=}}</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" |[[Rheumatoid factor|Rheumatoid factor (RF)]], [[S100A12]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Lymphocytosis]], [[Thrombocytopenia]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Myeloid-related proteins 8/14 (MRP8/14)
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Synovial]] [[hypertrophy]], Joint effusions
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Cerebral vasculitis]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Inflamed [[synovium]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Bone scan|Bone scanning]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Vascular congestion]], [[Extravasation|RBC extravasation]], Venular lumen occlusion
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Conventional [[radiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Rash|Evanescent rash]], [[Dactylitis]] 
|-
|}
</small>
==References==
==References==
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{{Reflist|2}}
[[Category:Needs content]]
[[Category:Diseases involving the fasciae]]
[[Category:Rheumatology]]
[[Category:Disease]]
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[[Category:Medicine]]
[[Category:Up-To-Date]]
[[Category:Rheumatology]]

Latest revision as of 21:23, 29 July 2020

Polyarteritis nodosa Microchapters

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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]

Overview

Polyarteritis nodosa must be differentiated from other diseases that cause may lead to medium vessel vasculitis. The diseases that can lead to medium vessel vasculitis are polyarteritis nodosa, kawasaki disease, infections, cardiovascular diseases and systemic diseases.

Differentiating Polyarteritis Nodosa from other Diseases

  • The following table differentiates polyarteritis nodosa from other diseases that may lead to medium vessel vasculitis.

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
Polyarteritis nodosa[1] + + + + + + +/- +/- LAMP-2 protein autoantibodies Leukocytosis, Normochromic anemia, Thrombocytosis Cr or BUN,

ALT or AST, Proteinuria

Focal regions of infarction or hemorrhage Multiple microaneurysms, Hemorrhage due to focal rupture, Occlusion Aneurysms and renal arteriovenous fistula in color Doppler sonography - Necrotizing inflammatory lesions Angiography Sudden weight loss, Abdominal pain
Hepatitis B virus-associated polyarteritis nodosa[2] +/- +/- + + +/- +/- + - HBsAg Leukocytosis, Normochromic anemia, Thrombocytosis ALT or AST Focal regions of infarction or hemorrhage Microaneurysms in mesenteric artery Aneurysms and renal arteriovenous fistula in color Doppler sonography - Necrotizing inflammatory lesions Angiography Peripheral neuropathy, Livedo reticularis
Kawasaki disease[3] - + +/- + + - +/- - NT-proBNP, Meprin A, Filamin C Normochromic anemia, ↑WBC with a left shift, Thrombocytosis  Acute-phase reactants, ↓Cholesterol, ↓HDL, ↓ApolipoA Coronary artery calcifications Coronary artery aneurysms, stenosis or occlusion Coronary artery anomaly in echocardiography Electron beam CT (EBCT) Acute destruction of the media by neutrophils, with loss of elastic fibers History and physical examination Diarrhea, Vomiting
Infectious disease Parvovirus B19 infection[4] + + + + - - - +/- B19 DNA, ↓Reticulocyte count Anemia anti–parvovirus B19 IgM - - Hydrops in fetal ultrasonography - - B19 DNA Purpuric rash, Erythema multiforme
Scarlet fever[5] + + +/- + - - - - Antistreptolysin-O (ASO) titers Leukocytosis CRP Thickened pulmonary markings if pneumonia - - - Sparse neutrophilic perivascular infiltrate History and physical examination Sand-paper rashes, Sore throat
Toxic shock syndrome[6] + + + + - - - +/- Procalcitonin Leukocytosis with left shift Myoglobinuria, Sterile pyuria Acute respiratory distress syndrome - - - Necrolysis of keratinocytes in epidermis, Perivascular lymphocytic infiltrate Clinical criteria Peeling or rashes, Organ dysfunction
Mononucleosis[7] + + + + - - - - EBV DNA Atypical lymphocyte Heterophile antibodies CNS involvement - Splenomegaly Encephalitis in MRI Lymphoproliferative response in oropharynx, Lymphocytic infiltration in spleen Heterophile antibody test Splenomegaly, Palatal petechiae
Leptospirosis[8] + + + + +/- - - - IL-6, IL-8 and IL-10 Anemia - Cr or BUN,

ALT or AST, Proteinuria

 Diffuse alveolar hemorrhage - - - Toxin-mediated break down of endothelial cell membranes of capillaries Culture and the microscopic agglutination test Red eyes, Skin rash
Lyme Disease[9] +/- + +/- + +/- - - - CXCL9 (MIG), CXCL10 (IP-10) and CCL19 (MIP3B) Leukopenia, Thrombocytopenia - Microscopic hematuria, Proteinuria, ↑ALT or AST Punctate lesions in periventricular white matter in brain SPECT - - - Acrodermatitis chronica atrophicans Serologic tests Erythema migrans
Measles[10] +/- + +/- + - - - - Measles IgM Leukopenia, Lymphocytosis, Thrombocytopenia - ALT or AST Pneumonia - - CXR Spongiosis and vesiculation in the epidermis with scattered dyskeratotic keratinocytes PCR Generalized rash, Cough, Coryza, or Conjunctivitis
Rocky Mountain Spotted Fever[11] + + + + - - - - R rickettsii serology Thrombocytopenia, Anemia  - ALT or AST, Hyponatremia Infarction, edema, and meningeal enhancement - Myocardial or conduction abnormalities in echocardiography - Immunofluorescent or immunoperoxidase staining of R rickettsii Clinical criteria and tick exposure Rash on the palms and soles
Staphylococcal Scalded Skin Syndrome[12] + + + + - - +/- +/- Anti exfoliatin and anti alpha-toxin antibodies Leukocytosis with left shift Blood culture Pneumonia - - - Intraepidermal blister, dense superficial perivascular lymphohistiocytic infiltrate  Blood culture and clinical findings Widespread skin erythema, fluid-filled blisters
Toxic Epidermal Necrolysis[13] - + + - - - - +/- MicroRNA-124 Normochromic normocytic anemia, Eosinophilia Fluid loss and electrolyte abnormalities Tracheobronchial inflammation - - - Necrotic keratinocytes with full-thickness epithelial necrosis Histopathology and clinical findings Erythematous macular rash with purpuric centers
Cardiovascular disease Atrial Myxoma[14] - - +/- - - - - +/- Calretinin Mild anemia, Leukocytosis IL-6 Atrial filling defect larger than a thrombus - Tumor location, size, attachment, and mobility in echocardiography Size, shape, and surface characteristics in MRI Lipidic cells embedded in a vascular myxoid stroma Echocardiography Dyspnea on exertion, Syncope
Cholesterol Embolism[15] +/- +/- - - + - - + IL-5 Eosinophilia, Leukocytosis   Eosinophiluria Thoracic and abdominal aortic sources of embolism Atheroembolism in abdominal aorta and the lower extremity arteries Excluding an intracardiac source of embolism with echocardiography  - Birefringent crystals or biconvex needle-shaped ghostly clefts within the arterial lumen Angiography  Livedo reticularis,

Ischemic patches

Segmental arterial mediolysis[16] + - - - + + + +/- - Leukocytosis - - Visceral artery aneurysm in CT angiography Alternating aneurysms and stenoses (beading) Retroperitoneal hematoma - Disruption of the smooth muscle in the media Angiography  Hematuria, Ischemic colitis
Systemic disease Antiphospholipid Syndrome[17] + + - - - - - +/- Antiphospholipid antibodies Thrombocytopenia, Hemolytic anemia - Lupus anticoagulant (LA) Stroke,

Pulmonary embolism, Budd-Chiari syndrome

Thrombus in major vessels Valve thickening, vegetations, or insufficiency in echocardiography - Noninflammatory bland thrombosis without perivascular inflammation Hx of thrombosis and antiphospholipid antibodies Miscarriage, Pulmonary hypertension
Juvenile Idiopathic Arthritis[18] - - - + +/- - - - Rheumatoid factor (RF), S100A12 Lymphocytosis, Thrombocytopenia Myeloid-related proteins 8/14 (MRP8/14) Synovial hypertrophy, Joint effusions Cerebral vasculitis Inflamed synovium Bone scanning Vascular congestion, RBC extravasation, Venular lumen occlusion Conventional radiography Evanescent rash, Dactylitis 

References

  1. Howard T, Ahmad K, Swanson JA, Misra S (2014). "Polyarteritis nodosa". Tech Vasc Interv Radiol. 17 (4): 247–51. doi:10.1053/j.tvir.2014.11.005. PMC 4363102. PMID 25770638.
  2. Sharma A, Sharma K (September 2013). "Hepatotropic viral infection associated systemic vasculitides-hepatitis B virus associated polyarteritis nodosa and hepatitis C virus associated cryoglobulinemic vasculitis". J Clin Exp Hepatol. 3 (3): 204–12. doi:10.1016/j.jceh.2013.06.001. PMC 4216827. PMID 25755502.
  3. Takahashi K, Oharaseki T, Yokouchi Y (2011). "Pathogenesis of Kawasaki disease". Clin Exp Immunol. 164 Suppl 1: 20–2. doi:10.1111/j.1365-2249.2011.04361.x. PMC 3095860. PMID 21447126.
  4. Heegaard ED, Brown KE (2002). "Human parvovirus B19". Clin Microbiol Rev. 15 (3): 485–505. PMC 118081. PMID 12097253.
  5. Basetti S, Hodgson J, Rawson TM, Majeed A (2017). "Scarlet fever: a guide for general practitioners". London J Prim Care (Abingdon). 9 (5): 77–79. doi:10.1080/17571472.2017.1365677. PMC 5649319. PMID 29081840.
  6. Vostral SL (2011). "Rely and Toxic Shock Syndrome: a technological health crisis". Yale J Biol Med. 84 (4): 447–59. PMC 3238331. PMID 22180682.
  7. Balfour HH, Dunmire SK, Hogquist KA (2015). "Infectious mononucleosis". Clin Transl Immunology. 4 (2): e33. doi:10.1038/cti.2015.1. PMC 4346501. PMID 25774295.
  8. Levett PN (April 2001). "Leptospirosis". Clin. Microbiol. Rev. 14 (2): 296–326. doi:10.1128/CMR.14.2.296-326.2001. PMC 88975. PMID 11292640.
  9. Biesiada G, Czepiel J, Leśniak MR, Garlicki A, Mach T (2012). "Lyme disease: review". Arch Med Sci. 8 (6): 978–82. doi:10.5114/aoms.2012.30948. PMC 3542482. PMID 23319969.
  10. White SJ, Boldt KL, Holditch SJ, Poland GA, Jacobson RM (2012). "Measles, mumps, and rubella". Clin Obstet Gynecol. 55 (2): 550–9. doi:10.1097/GRF.0b013e31824df256. PMC 3334858. PMID 22510638.
  11. Walker DH (1989). "Rocky Mountain spotted fever: a disease in need of microbiological concern". Clin Microbiol Rev. 2 (3): 227–40. PMC 358117. PMID 2504480.
  12. Mishra AK, Yadav P, Mishra A (2016). "A Systemic Review on Staphylococcal Scalded Skin Syndrome (SSSS): A Rare and Critical Disease of Neonates". Open Microbiol J. 10: 150–9. doi:10.2174/1874285801610010150. PMC 5012080. PMID 27651848.
  13. Hoetzenecker W, Mehra T, Saulite I, Glatz M, Schmid-Grendelmeier P, Guenova E; et al. (2016). "Toxic epidermal necrolysis". F1000Res. 5. doi:10.12688/f1000research.7574.1. PMC 4879934. PMID 27239294.
  14. MacGowan SW, Sidhu P, Aherne T, Luke D, Wood AE, Neligan MC, McGovern E (June 1993). "Atrial myxoma: national incidence, diagnosis and surgical management". Ir J Med Sci. 162 (6): 223–6. PMID 8407260.
  15. Avci G, Akoz T, Gul AE (2009). "Cutaneous cholesterol embolization". J Dermatol Case Rep. 3 (2): 27–9. doi:10.3315/jdcr.2009.1031. PMC 3157794. PMID 21886725.
  16. Chao, Christine (2009). "Segmental Arterial Mediolysis". Seminars in Interventional Radiology. 26 (03): 224–232. doi:10.1055/s-0029-1225666. ISSN 0739-9529.
  17. Chaturvedi S, McCrae KR (2015). "The antiphospholipid syndrome: still an enigma". Hematology Am Soc Hematol Educ Program. 2015: 53–60. doi:10.1182/asheducation-2015.1.53. PMC 4877624. PMID 26637701.
  18. Espinosa M, Gottlieb BS (July 2012). "Juvenile idiopathic arthritis". Pediatr Rev. 33 (7): 303–13. doi:10.1542/pir.33-7-303. PMID 22753788.

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