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Dina Elantably, MD, MSc[1]


Huda A. Karman, M.D.

Dina Elantably, MD, MSc[2]



AF [2]


Atrial fibrillation

Insulin

Functions

  1. Bind insulin receptors
    1. inducing glucose uptake into insulin dependent tissue
    2. gene transcription
glucose is the major regulator of insulin release to incretins.

Diabetes mellitus It could be due to genetic , enviromental or immune defects.


Regulation of insulin

glucose is the main substrate for the brain


Thyroid disorders
Findings hypothyroidism Hyperthyroidism


proinsulin and c-peptide

Complications of diabetes:

  1. Major complications
  2. Minor complications
  3. Emergency situations

11 β- hydroxylase deficiency

21 α-hydroxylase deficiency

  1. redirectDiabetes Mellitus


The pathogenesis of chronic recalcitrant hand eczema and its dramatic response to alitretinoin is not yet known. [3]

References

  1. Spicer DE, Hsu HH, Co-Vu J, Anderson RH, Fricker FJ (2014). "Ventricular septal defect". Orphanet J Rare Dis. 9: 144. doi:10.1186/s13023-014-0144-2. PMC 4316658. PMID 25523232.
  2. Jennette JC, Falk RJ, Bacon PA et al (2013) 2012 Revised international Chapel Hill consensus conference nomenclature of vasculitides. Arthritis Rheum 65:1–11. https://doi.org/10.1002/art.37715
  3. Nada, Hanan Rabea; Rashed, Laila Ahmed; Elantably, Dina Mahmoud Mustafa; El Sharkawy, Dina Ahmed (2020). "Expression of retinoid receptors in hand eczema". International Journal of Dermatology. 59 (5): 576–581. doi:10.1111/ijd.14830. ISSN 0011-9059.


The 2012 Chapel Hill Consensus Conference (CHCC) classified the vasculitides as follows:
Large Vessel Vasculitis
Takayasu arteritis
Giant cell arteritis
Medium vessel vasculitis
Polyarteritis nodosa
Kawasaki disease
Small vessel vasculitis
ANCA-associated vasculitis: Microscopic polyangiitis, Granulomatosis with polyangiitis (Wegener's), and Eosinophilic granulomatosis with polyangiitis (Churg-Strauss).
Immune complex small-vessel vasculitis: Anti-glomerular basement membrane disease, Cryoglobulinemic vasculitis, IgA vasculitis (Henoch-Schönlein), and Hypocomplementemic urticarial vasculitis (anti-C1q vasculitis)
Variable-vessel vasculitis
Behçet's syndrome
Cogan's syndrome
Single-organ vasculitis
Cutaneous leukocytoclastic angiitis
Cutaneous arteritis
Primary central nervous system vasculitis
Isolated aortitis
Vasculitis associated with systemic disease
Lupus vasculitis
Rheumatoid vasculitis
Sarcoid vasculitis
Others
Vasculitis associated with probable etiology
Hepatitis C virus-associated cryoglobulinemic vasculitis
Hepatitis B virus-associated vasculitis
Syphilis-associated aortitis
Drug-associated immune complex vasculitis
Drug-associated ANCA-associated vasculitis
Cancer-associated vasculitis
other

Diagnosis of PSV is based on a combination of clinical, laboratory, histopathological and radiological features

 
 
 
History suggestive of vasculitis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Clinical Findings
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Laboratory tests C02= Additional tests
 
{{{ C02 }}}
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Labs: To exclude vasculitis “mimics” and secondary causes Blood cultures

Echocardiogram

Hepatitis screen (B and C)

HIV test

Antiglomerular basement membrane antibody

Antiphospholipid antibodies

Antinuclear antibody

To assess extent of vasculitis Urine dipstick and microscopy (all patients)

Chest radiography (all patients)

Nerve conduction studies/electromyography/CK

To confirm diagnosis of vasculitis Biopsy and/or angiogram

To identify the specific type of vasculitis ANCA

Cryoglobulin

Complement levels

Eosinophil counts/IgE levels

Specific findings on biopsy (necrotising granulomatous inflammation, presence of IgA deposits, evidence of immune complex formation (or its absence)) [1]

  1. Suresh E. (2006). Diagnostic approach to patients with suspected vasculitis. Postgraduate medical journal, 82(970), 483–488. https://doi.org/10.1136/pgmj.2005.042648