Vasculitis
Vasculitis is a term to describe multisystem diseases, broadly classified by the size of involved blood vessels. Vasculitis is suggested by a spectrum of clinical and laboratory features.
Clinical:
- Fever, weight loss, persistent fatigue.
- Skin rash: e.g., palpable purpura, vasculitic urticaria, nodules, ulcers, mouth ulcers.
- Neurologic signs: e.g., headache, mononeuritis multiplex, focal neurological lesions (stroke).
- Arthritis or arthralgia, myalgia or myositis.
- Hypertension, cardiac failure, unequal pulses.
- Testicular pain.
- Oliguria, oedema.
- Pulmonary infiltrates or haemorrhage.
Laboratory:
- Increased acute-phase reactants (ESR, CRP).
- Anaemia, Leukocytosis, Eosinophilia.
- Antineutrophil cytoplasmic antibodies (ANCA).
- Elevated factor VIII - related antigen (von Willebrand factor).
- Haematuria and active urine sediment.
The most common childhood vasculitides are Henoch – Schönlein purpura (HSP) / IgA vasculitis and Kawasaki Disease (KD). In Southern Africa Takayasu’s Arteritis is not uncommon.
The photograph below shows a 'target lesion' of skin vasculitis
The photograph below shows vasculitic ulcers due to polyarteritis nodosa
The photograph below shows livedo reticularis over the knee - a mottled skin appearance that associates with vasculitis and antiphospholipid syndromes
The photograph below shows ischaemic fingers in vasculitis with antiphospholipid syndrome
The photograph below shows an aphthous ulcer as a feature of small vessel vasculitis
