Vasculitis diagnostic criteria: Difference between revisions

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{{Vasculitis}}
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{{CMG}}; '''Associate Editor-In-Chief:''' {{MUT}}
{{CMG}}; {{AE}} {{MUT}}


==Overview==
==Overview==

Revision as of 17:40, 20 June 2016

Vasculitis

Overview

Classification

Large-sized vessel vasculitis
Takayasu's Arteritis
Temporal Arteritis
Medium-sized vessel vasculitis
Kawasaki's Disease
Polyarteritis Nodosa
Small-sized vessel vasculitis
Churg-Strauss Syndrome
Cutaneous leukocytoclastic vasculitis
Essential cryoglobulinemic vasculitis
Henoch-Schonlein Purpura
Microscopic polyangiitis
Wegener's Granulomatosis
Variable-sized vessel vasculitis
Sjogren syndrome
Cogan syndrome
Single organ vasculitis
Primary central nervous system angiitis

Causes

Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M.Umer Tariq [2]

Overview

Diagnostic Criteria

Takayasu arteritis

At least 3 out of 6 criteria yields sensitivity and specificity of 90.5 and 97.8%:

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%:

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 arteritis

At least 4 criteria yields sensitivity and specificity of 85 and 99.7%.

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%:


References

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