Vasculitis

Last updated: Thursday, 17, February, 2011
ClassificationAppropriate 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 antibodies (ANCA).

Extent of disease is assessed by diagnostic imaging; creatinine - plasma, urea - plasma; ALP, AST, ALT, GGT.

Activity of disease is evaluated by CRP or ESR, occasionally complement components C3 and C4.

Investigation for the underlying cause may include rheumatoid factor, cryoglobulin, protein electrophoresis, antinuclear antibodies, hepatitis B virus testing, hepatitis C virus testing, and HIV testing.

Systemic necrotising

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

Polyarteritis nodosa

Microscopic polyangiitis

Wegener's granulomatosis

Mucocutaneous lymph node syndrome (Kawasaki's dicease)

Churg-Strauss syndrome

Small vessel, including leucocytoclastic

 

Drug reaction, especially

  • Frusemide
  • Thiazides
  • Allopurinol

Connective tissue diseases, especially 

Henoch-Schonlein purpura

See also Glomerulonephritis

Cryoglobulinaemia

Large vessel, especially

Giant cell arteritis

  • Temporal arteritis 

Thrombo-angiitis obliterans (Buerger's disease)

Takayasu's disease

Erythema nodosum

Behcet's syndrome