Vasculitis
- very rare in real life
- organ specific symptoms because vessel lumen occludes
- increase blood flow or hyperemia: blanch when pressed
- see palpable purpura = vasculitis
Large Vessel
Temporal Arteritis
- face and head symptoms
- ophthalmic artery from internal carotid
- High ESR: classic
- granuloma
- high IL6
Takayasu
- picture: narrowing of left subclavian artery
- weak upper extremity pulse
- cold/numb fingers
- granuloma on histology
Medium Vessel
Kawasaki
- acute: 1st 2 weeks, fever, arthritis, myocarditis, rash
- subacute: skin falls off, aneurysm
Scarlet
- scarlet fever: sore throat
Reye
Buerger
- aka thromboangiitis obliterans
- male smokers. Almost never in nonsmokers
- segmental thrombosing vasculitis: blood clots cut off blood to hands/feet
- distal claudication and ulcers
- characterized histologically by intraluminal thrombus and prominent inflammatory cell infiltrate with relative sparing of the vessel wall.
PAN
- deposit in many places, wide variety of symptoms
- ischemia and renal failure
Small vessels
HS purpura
- complement activated via alternative/lectin pathway. IgA does not fix complement
- biopsy shows IgA deposition
ANCA
- pulmonary different for each; renal similar for all 3
- lower right: negative IF, no Ig
Churg Strauss
- looks like asthma as adule first time refractory to medical therapy
- classic case: adult onset asthma with palpable purpura, eosinophila, p-ANCA
Wegener
- saddle nose due to ulcers
Microscopic polyangitis
Goodpasture
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