Vasculitis

Classification

Appropriate Tests

 

Diagnosis and classification of vasculitis is based on the findings at biopsy of the affected tissue/organ, together with the clinical picture and the results of Antineutrophil cytoplasmic Ab (ANCA).

Extent of disease is assessed by diagnostic imaging; Creatinine, Urea, Alkaline phosphatase, Aspartate aminotransferase, Alanine aminotransferase, Gamma glutamyltransferase.

Activity of disease is evaluated by C-Reactive protein, Erythrocyte sedimentation rate, occasionally Complement components C3 and C4.

Investigation for the underlying cause may include Rheumatoid factor, Cryoglobulins, Protein electrophoresis, Antinuclear Ab, Hepatitis B serology, Hepatitis C serology, and HIV testing.

Systemic necrotising

Clinical assessment. Antineutrophil cytoplasmic Ab and complement assist in the differentiation of Polyarteritis nodosa, and other vasculitides, from ANCA positive vasculitides that involve a broader range of vessels.

Polyarteritis nodosa

 

Microscopic polyangiitis

 

Granulomatosis with polyangiitis

 

Mucocutaneous lymph node syndrome (Kawasaki's disease)

 

Churg-Strauss syndrome

 

Small vessel, including leucocytoclastic

 

Drug reaction, especially

  • Frusemide
  • Thiazides
  • Allopurinol

 

Connective tissue diseases, especially 

  • Rheumatoid arthritis
  • SLE

 

Henoch-Schonlein purpura

See also Glomerulonephritis (GN)

Cryoglobulinaemia

 

Large vessel, especially

 

Giant cell arteritis

 

  • Temporal arteritis

 

Thrombo-angiitis obliterans (Buerger's disease)

 

Takayasu's disease

 

Erythema nodosum

 

Behcet's syndrome