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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

 

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