Vasculitis

IMENE BENAYACHE.MD

SINOE MEDICAL ASSOCIATION

Vasculitis.

v They could be covered in:

· Cardiovascular or

· Rhumatology.

Ø Non atherosclerotic causes of MI.

ü Vasculitis.

1. SLE

2. Polyarteritis nodosa (PAN)

3. Takayasu`s arteritis.

4. Kawasaki`s disease.

ü Coronary artery embolus.

1. Atrial myxoma.

2. Atrial or ventricular thrombus.

Ø Other vasculitis.

1. Wegner`s Granulomatosis.

2. Temporal arteritis.

3. Thromboangiitis obliterans “Buerger disease”

4. Raynaud`s disease.

5. Hypersensitivity vasculitis syndrome.

v Descriptions :

Inflammation of a vessel of different diameters leading to infarction because of thrombosis, weakening of vessels resulting in aneurysm and rupture.

A/. Systemic lupus erythematous.(SLE)

· Cause: unknown (genetic, environmental).

· Pathogenesis: production of antibodies and immune complexes.

· Female > male, African-American.90%.

· Musculoskeletal muscle involved in 95%.

***CVx manifestation: thrombosis of small and medium vessels.

· Libman-Sacks endocarditis (nonbacterial verrucous endocarditis affecting mitral and tricuspid valves).

· Pericarditis.

B/.PAN.

· Necrotizing immune vasculitis of small to medium arteries.

· Male > Female.

· Pathogenesis: immune complex deposition and activation of neutrophils and monocyte by anti-neutrophil cytoplasmic antibody.

· A lot of organs involved with infarction (heart 75%).

C/.Takayasu`s arteritis or disease.

· Also known as pulseless disease.

· Granulomatous vasculitis that involves the aortic arch vessels in young women, particularly Asians.

· Pathogenesis: cell mediated hypersensitivity to Ag in vessl wall, or existance of HLA.

· CVx: angina, infarction, aortic regurgitation.

D/.Kawasaki`s disease.

· Also known as mucocutaneous lymph node syndrome.

· Febrile disease of children produce a systemic vasculitis.

· Involves coronary arteries (coronary aneurysm is a complication).

· Characteristic of the disease, strawberry tongue.

E/.Wegner`s Granulomatosis.

· Necrotizing granulomatous vasculitis of small arteries and veins .

· Male > Female.

· Pathogenesis: immune complex, Ab against vessel.

F/.Temporal arteritis.

· Granulomatous vasculitis of the temporal arteries and branches of internal carotid artery.

· Also called giant cell arteritis.

· Elderly women.

· Cell mediated immunity against arterial Ag in the media of smooth muscle cells.

· Complication: blindness.

G/.Buerger`s disease.

· Involves medium size vessel especially tibial and radial.

· Male, cigarette smokers.

· Patho: HLA + cigarette

· Cell mediated immune reaction, damage endothelium.

· Cpl: ulceration, gangrene, loss of digit.

· Ceases when stop smoking but at the beginning.

H/.Raynaud`s disease.

· Arterial insufficiency to the extremities (hand, feet).

· due to vasospasm of vessel.

· Triggered by cold.

· Secondary thickening of vessels.

· Manifestation depends on the etiology.

I/.HYPERSENSITIVITY VASCULITIS OR MICROSCOPIC “PAN”.

· Group of syndrome involving small vessels( postcapillary venules).

·