Vasculitis
Vasculitis is a term to describe multisystem diseases, broadly classified by the size of involved blood vessels.
Features suggesting a vasculitis in adolescents and children
Clinical
- Fever, weight loss, persistent fatigue
- Skin rash: e.g palpable purpura, vasculitic urticaria, nodules, ulcers, mouth ulcers
- Neurologic signs: headache, mononeuritis multiplex, focal neurological lesions (stroke)
- Arthritis or arthralgia, myalgia or myositis
- Hypertension, cardiac failure, unequal pulses
- Testicular pain
- Oliguria, haematuria, 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
The most common childhood vasculitides are Henoch – Schönlein purpura (HSP) and Kawasaki Disease (KD)
The following photographs demonstrate examples of vasculitis involving different systems
The photograph below shows a 'target lesion'
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
