Large-sized vessel vasculitis with claudication: Difference between revisions
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Created page with "__NOTOC__ {{CMG}}; {{AE}} {{EG}} <span style="font-size:85%">'''Abbreviations:''' ABG= Arterial blood gas, ANA= Antinuclear antibody, ANP= Atrial natriuretic pepti..." |
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<span style="font-size:85%">'''Abbreviations:''' | <span style="font-size:85%">'''Abbreviations:''' | ||
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> | 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> | ||
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{| style="border: 0px; font-size: 90%; margin: 3px;" align="center" | {| style="border: 0px; font-size: 90%; margin: 3px;" align="center" | ||
! colspan="3" rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Diseases | ! colspan="3" rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Diseases | ||
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! style="background:#4479BA; color: #FFFFFF;" align="center" |Other | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Other | ||
|- | |- | ||
! rowspan=" | ! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Large-Vessel Vasculitis | ||
! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Takayasu arteritis]]<ref name="pmid23626437">{{cite journal| author=Vaideeswar P, Deshpande JR| title=Pathology of Takayasu arteritis: A brief review. | journal=Ann Pediatr Cardiol | year= 2013 | volume= 6 | issue= 1 | pages= 52-8 | pmid=23626437 | doi=10.4103/0974-2069.107235 | pmc=3634248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23626437 }}</ref> | ! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Takayasu arteritis]]<ref name="pmid23626437">{{cite journal| author=Vaideeswar P, Deshpande JR| title=Pathology of Takayasu arteritis: A brief review. | journal=Ann Pediatr Cardiol | year= 2013 | volume= 6 | issue= 1 | pages= 52-8 | pmid=23626437 | doi=10.4103/0974-2069.107235 | pmc=3634248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23626437 }}</ref> | ||
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+ | ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+ | ||
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! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Coronary aneurysm]] | ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Coronary aneurysm]] | ||
|- | |- | ||
! | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Neurological disease]] | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Neurofibromatosis type 2]]<ref name="Evans2000">{{cite journal|last1=Evans|first1=D G. R|title=Neurofibromatosis type 2|journal=Journal of Medical Genetics|volume=37|issue=12|year=2000|pages=897–904|issn=14686244|doi=10.1136/jmg.37.12.897}}</ref> | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Neurofibromatosis type 2]]<ref name="Evans2000">{{cite journal|last1=Evans|first1=D G. R|title=Neurofibromatosis type 2|journal=Journal of Medical Genetics|volume=37|issue=12|year=2000|pages=897–904|issn=14686244|doi=10.1136/jmg.37.12.897}}</ref> | ||
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/- | ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/- | ||
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! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hearing loss]], [[Vision loss]] | ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hearing loss]], [[Vision loss]] | ||
|- | |- | ||
! rowspan=" | ! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Systemic disease]] | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Fibromuscular dysplasia]]<ref name="pmid17555581">{{cite journal| author=Plouin PF, Perdu J, La Batide-Alanore A, Boutouyrie P, Gimenez-Roqueplo AP, Jeunemaitre X| title=Fibromuscular dysplasia. | journal=Orphanet J Rare Dis | year= 2007 | volume= 2 | issue= | pages= 28 | pmid=17555581 | doi=10.1186/1750-1172-2-28 | pmc=1899482 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17555581 }}</ref> | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Fibromuscular dysplasia]]<ref name="pmid17555581">{{cite journal| author=Plouin PF, Perdu J, La Batide-Alanore A, Boutouyrie P, Gimenez-Roqueplo AP, Jeunemaitre X| title=Fibromuscular dysplasia. | journal=Orphanet J Rare Dis | year= 2007 | volume= 2 | issue= | pages= 28 | pmid=17555581 | doi=10.1186/1750-1172-2-28 | pmc=1899482 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17555581 }}</ref> | ||
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+ | ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+ | ||
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! style="padding: 5px 5px; background: #F5F5F5;" align="center" |History and [[physical examination]] | ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |History and [[physical examination]] | ||
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Bleeding]], [[Easy bruising|Bruisability]], [[Heart murmur]] | ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Bleeding]], [[Easy bruising|Bruisability]], [[Heart murmur]] | ||
|- | |- | ||
! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Amyloidosis]]<ref name="pmid23227278">{{cite journal| author=Baker KR, Rice L| title=The amyloidoses: clinical features, diagnosis and treatment. | journal=Methodist Debakey Cardiovasc J | year= 2012 | volume= 8 | issue= 3 | pages= 3-7 | pmid=23227278 | doi= | pmc=3487569 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23227278 }}</ref> | ! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Amyloidosis]]<ref name="pmid23227278">{{cite journal| author=Baker KR, Rice L| title=The amyloidoses: clinical features, diagnosis and treatment. | journal=Methodist Debakey Cardiovasc J | year= 2012 | volume= 8 | issue= 3 | pages= 3-7 | pmid=23227278 | doi= | pmc=3487569 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23227278 }}</ref> | ||
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</small> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} |
Revision as of 16:28, 9 April 2018
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
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 | ||||||
Large-Vessel Vasculitis | Takayasu arteritis[1] | + | +/- | + | - | + | + | +/- | +/- | MMP-3 and MMP-9 | Leukocytosis, Anemia | ↑ | ↑CRP | Aneurysmal dilatation of the aorta | Blood vessel stenosis | Circumferential thickening of the arterial wall (Macaroni sign) | PET-scan, Cardiac CT | Granulomatous inflammation of arteries | Arteriography | Coronary aneurysm | |
Neurological disease | Neurofibromatosis type 2[2] | +/- | - | +/- | - | +/- | - | - | + | NF2 mutated gene | Normal | Normal | Schwannomin | Meningioma, Schwannoma, Ependymoma | Fluorescein angiography showed retinal hamartoma | Localized schwannomas in nerve ultrasound | Schwannoma in MRI | Encapsulated biphasic nerve sheath tumor | NIH diagnostic criteria | Hearing loss, Vision loss | |
Systemic disease | Fibromuscular dysplasia[3] | + | - | +/- | + | + | + | + | +/- | Transforming growth factor β (TGF-β) | Normal | ↑ | ↑ Cr or BUN | Alternating stenosis and dilatations in CT angiography | Stenosis in the renal arteries | Luminal narrowing alternating with dilatation (Beads sign) | Focal concentric, long-segment tubular stenosis or outpouching in MRA | Fibrodysplastic changes, Collagen deposition | Digital subtraction angiography (DSA) | Spontaneous coronary artery dissection (SCAD) | |
Ehlers-Danlos syndrome[4] | - | - | - | + | +/- | +/- | - | +/- | TGF-β | Normal | Normal | Cultured skin fibroblasts | Multiple vascular segments with aneurysms and dissections | Dissection of the posterolateral branch of the left circumflex coronary artery (LCx) | Visceral arteries abnormality | Vascular abnormalities in MRA | Thin and rare collagen bundles in the dermis | History and physical examination | Bleeding, Bruisability, Heart murmur | ||
Amyloidosis[5] | +/- | - | - | +/- | +/- | - | + | + | Immunoglobulin light chain(Amyloid) | Anemia | Normal | ↑ Cr or BUN, | Diffusely hypoattenuating and enlarged liver | Amyloid deposition in the media and adventitia of small arteries | Solid organs increased echogenicity | Tc-DPD for cardiac amyloid deposits | Extracellular deposition of fibrillar proteins | Biopsy | Cardiomegaly, Dyspnea |
References
- ↑ Vaideeswar P, Deshpande JR (2013). "Pathology of Takayasu arteritis: A brief review". Ann Pediatr Cardiol. 6 (1): 52–8. doi:10.4103/0974-2069.107235. PMC 3634248. PMID 23626437.
- ↑ Evans, D G. R (2000). "Neurofibromatosis type 2". Journal of Medical Genetics. 37 (12): 897–904. doi:10.1136/jmg.37.12.897. ISSN 1468-6244.
- ↑ Plouin PF, Perdu J, La Batide-Alanore A, Boutouyrie P, Gimenez-Roqueplo AP, Jeunemaitre X (2007). "Fibromuscular dysplasia". Orphanet J Rare Dis. 2: 28. doi:10.1186/1750-1172-2-28. PMC 1899482. PMID 17555581.
- ↑ Gazit Y, Jacob G, Grahame R (2016). "Ehlers-Danlos Syndrome-Hypermobility Type: A Much Neglected Multisystemic Disorder". Rambam Maimonides Med J. 7 (4). doi:10.5041/RMMJ.10261. PMC 5101008. PMID 27824552.
- ↑ Baker KR, Rice L (2012). "The amyloidoses: clinical features, diagnosis and treatment". Methodist Debakey Cardiovasc J. 8 (3): 3–7. PMC 3487569. PMID 23227278.