{"id":8082,"date":"2021-11-13T11:00:06","date_gmt":"2021-11-13T09:00:06","guid":{"rendered":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/vascular-pathology\/inflammatory-vascular-diseases\/vasculitides\/"},"modified":"2021-12-24T15:43:42","modified_gmt":"2021-12-24T13:43:42","slug":"vasculitides","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/vascular-pathology\/inflammatory-vascular-diseases\/vasculitides\/","title":{"rendered":"Vasculitides"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Inflammation of the vessel wall.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Infectious<\/li><li>Non-infectious<\/li><\/ul>\n\n\n<span class=\"block-heading\" id=\"header_1\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Infectious<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<ul class=\"wp-block-list\"><li>Most commonly, fungi &#8212; Aspergillus<\/li><li>Usually due to systemic infections in immune compromised<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Non-infectious<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<p class=\"wp-block-paragraph\">Caused due to autoimmune reactions.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Many specific types are known and they are classified based on their characteristic features, mainly the types of vessels they affect, but in general &#8212; they overlap in their presentation.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Mechanisms<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<p class=\"wp-block-paragraph\">To this day, most vasculitides have an unknown etiology; however, there have been three suggested mechanisms:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Immune complex deposition<\/strong><\/li><li><strong>Neutrophil-mediated<\/strong><\/li><li><strong>Anti-endothelial activity<\/strong><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Immune complex deposition<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<p class=\"wp-block-paragraph\">Some vasculitides are caused due to the presence of immune complexes within vessel walls.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Types:<ul><li><strong>Drug hypersensitivity<\/strong><ul><li>In some cases, drugs such as penicillin bind to proteins and act as antigens to which antibodies can bind<\/li><\/ul><\/li><li><strong>Secondary to infections<\/strong><ul><li>Antibodies binding to circulating microbial antigens<\/li><li>Most notably &#8212; <strong>Hepatitis B<\/strong> surface antigens (HBsAg) forming complexes with anti-HBsAg antibodies, leading to <strong>polyarteritis nodosa<\/strong><\/li><\/ul><\/li><\/ul><\/li><li>It is difficult to identify:<ul><li>Whether the complexes formed within the tissues, or they were deposited from the circulation<\/li><li>The precise antigen responsible<\/li><\/ul><\/li><li>The&nbsp;<strong>absence&nbsp;<\/strong>of immune complexes is known as&nbsp;<strong>pauci-immune<\/strong><\/li><li>Hypersensitivity type III<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Neutrophil-mediated<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<p class=\"wp-block-paragraph\">Many types of vasculitides are caused due to abnormal neutrophil activity, caused by <strong>anti-neutrophil cytoplasmic antibodies&nbsp;<\/strong>(or&nbsp;<strong>ANCAs<\/strong>).<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>ANCAs are autoantibodies that react with certain cytoplasmic components of neutrophils<\/li><li>ANCAs bind to cytoplasmic antigens and translocate to the cytosol, causing the activation of neutrophils and the release of ROS, causing tissue destruction<\/li><li>There are many types of ANCAs, two of which are most important:<ul><li>Anti-proteinase-3, commonly known as <strong>c-ANCA<\/strong><ul><li>Proteinase-3 is an enzyme located within azurophilic granules<\/li><li>Associated with&nbsp;<strong>granulomatosis with polyangitis<\/strong><\/li><\/ul><\/li><li>Anti-myeloperoxidase, commonly known as <strong>p-ANCA<\/strong><ul><li>Myeloperoxidase (or MPO) is an enzyme involved with the generation of free radicals<\/li><li>Associated with&nbsp;<strong>microscopic polyangiitis&nbsp;<\/strong>and&nbsp;<strong>Churg-Stauss syndrome<\/strong><\/li><\/ul><\/li><\/ul><\/li><li>ANCAs do not form immune complexes (pauci-immune)<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_6\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Anti-endothelial activity<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_6\">\n\n\n<ul class=\"wp-block-list\"><li>Autoantibodies against endothelial cells<ul><li>Associated with Kawasaki&#8217;s disease<\/li><\/ul><\/li><li>Autoreactive T-cells<ul><li>Associated with vasculitidies that form granulomas<\/li><\/ul><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_7\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Summary of non-infectious vasculitidies<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_7\">\n\n\n<figure class=\"wp-block-table\"><table class=\"pure-table\"><tbody><tr><td>Type<\/td><td>Typical location<\/td><td>Suggested etiology<\/td><td>Manifestation<\/td><td>Epidemiology<\/td><\/tr><tr><td>Giant cell (temporal) arteritis<\/td><td>Arteries of the head<\/td><td>Anti-endothelial activity<\/td><td>Granulomas with giant cells and lymphocytes Elastic membrane fragmentation<\/td><td>Older adults<\/td><\/tr><tr><td>Takayasu arteritis<\/td><td>Aorta (arch and branching points)<\/td><td>Unknown<\/td><td>Granulomas with giant cells and lymphocytes<\/td><td>Young Asian females<\/td><\/tr><tr><td>Polyarteritis nodosa (PAN)<\/td><td>Small and medium-sized muscular arteries of the viscera, <strong>without<\/strong> affecting the lungs<\/td><td>Immune complex deposition (HBV) in 1\/3 of patients<\/td><td><strong>Fibrinoid necrosis<\/strong> Multiple lesions of different age along a single vessel, seen as hardened &#8220;nodes&#8221; &#8212; &#8220;beads-on-a-string&#8221; appearance Transmural necrotizing inflammation Impaired perfusion weakening vessel wall leading to aneurysms and rupture<\/td><td>Young adults<\/td><\/tr><tr><td>Kawasaki disease<\/td><td>Coronaries<\/td><td>Anti-endothelial activity<\/td><td>Oral and conjunctival blisters Rash on the hands and feet Lymphadenopathy Can rupture or progress to aneurysms<\/td><td>&gt;4yo Asian children<\/td><\/tr><tr><td>Microscopic polyangiitis<\/td><td>Small vessels and capillaries, most commonly the lungs and kidneys<\/td><td>p-ANCA<\/td><td><strong>Pauci-immune in most<\/strong> Fibrinoid necrosis The lesions are all of the same age (unlike PAN) Can affect any tissue, causing hemoptysis, hematuria, and palpable cutaneous purpura<\/td><td><\/td><\/tr><tr><td>Wegner&#8217;s granulomatosis (granulomatosis with polyangiitis)<\/td><td>Small to medium-sized arteries<\/td><td>c-ANCA<\/td><td>Granulomas A triad of affected organs<strong>:<\/strong> Upper respiratory tract Lungs Kidneys<\/td><td><\/td><\/tr><tr><td>Buerger disease<\/td><td>Small to medium arteries<\/td><td>Smoking<\/td><td>Fibrosis of internal elastic membrane &#8212; &#8220;Spanish collar&#8221; Thrombosis Affects the nerves, causing pain<\/td><td>Young male smokers<\/td><\/tr><tr><td>Churg-Strauss syndrome<\/td><td>Small vessels<\/td><td>p-ANCA<\/td><td>Granulomas Eosinophilia Asthma Allergic rhinitis Cardiac involvement in 60% of cases, a major cause of death<\/td><td><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<ul class=\"wp-block-list\"><li>Giant cell arteritis requires immediate treatment to prevent involvement of the ophthalmic arteries, which will cause blindness<\/li><li>Takayasu disease is also known as &#8220;pulseless disease&#8221;, since in its advanced stages, the lesions may cause reduced upper-extremity blood pressure and pulse strength<\/li><li>Kawasaki&#8217;s disease is treated with Aspirin (contrary to usual indication against Aspirin for children)<\/li><li>PAN and microscopic polyangiitis somewhat resemble each other<\/li><\/ul>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Infectious<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Non-infectious<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Mechanisms<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Immune complex deposition<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Neutrophil-mediated<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Anti-endothelial activity<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Summary of non-infectious vasculitidies<\/h3><\/div>","protected":false},"excerpt":{"rendered":"<p>Inflammation of the vessel wall. Infectious Non-infectious Infectious Most commonly, fungi &#8212; Aspergillus Usually due to systemic infections in immune compromised Non-infectious Caused due to autoimmune reactions. Many specific types are known and they are classified based on their characteristic features, mainly the types of vessels they affect, but in general &#8212; they overlap in [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":8079,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-8082","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Vasculitides &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/vascular-pathology\/inflammatory-vascular-diseases\/vasculitides\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/vascular-pathology\\\/inflammatory-vascular-diseases\\\/vasculitides\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/vascular-pathology\\\/inflammatory-vascular-diseases\\\/vasculitides\\\/\",\"name\":\"Vasculitides &#8211; Meddists\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/#website\"},\"datePublished\":\"2021-11-13T09:00:06+00:00\",\"dateModified\":\"2021-12-24T13:43:42+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/vascular-pathology\\\/inflammatory-vascular-diseases\\\/vasculitides\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/vascular-pathology\\\/inflammatory-vascular-diseases\\\/vasculitides\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/vascular-pathology\\\/inflammatory-vascular-diseases\\\/vasculitides\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\\\/\\\/meddists.com\\\/learn\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Pre-clinical\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Pathology\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Vascular pathology\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/vascular-pathology\\\/\"},{\"@type\":\"ListItem\",\"position\":5,\"name\":\"Inflammatory vascular diseases\",\"item\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/vascular-pathology\\\/inflammatory-vascular-diseases\\\/\"},{\"@type\":\"ListItem\",\"position\":6,\"name\":\"Vasculitides\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/#website\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/\",\"name\":\"Meddists\",\"description\":\"Let&#039;s Get Studying\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/meddists.com\\\/learn\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Vasculitides &#8211; Meddists","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/vascular-pathology\/inflammatory-vascular-diseases\/vasculitides\/","twitter_misc":{"Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/vascular-pathology\/inflammatory-vascular-diseases\/vasculitides\/","url":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/vascular-pathology\/inflammatory-vascular-diseases\/vasculitides\/","name":"Vasculitides &#8211; Meddists","isPartOf":{"@id":"https:\/\/meddists.com\/learn\/#website"},"datePublished":"2021-11-13T09:00:06+00:00","dateModified":"2021-12-24T13:43:42+00:00","breadcrumb":{"@id":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/vascular-pathology\/inflammatory-vascular-diseases\/vasculitides\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/vascular-pathology\/inflammatory-vascular-diseases\/vasculitides\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/vascular-pathology\/inflammatory-vascular-diseases\/vasculitides\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/meddists.com\/learn\/"},{"@type":"ListItem","position":2,"name":"Pre-clinical","item":"https:\/\/meddists.com\/learn\/pre-clinical\/"},{"@type":"ListItem","position":3,"name":"Pathology","item":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/"},{"@type":"ListItem","position":4,"name":"Vascular pathology","item":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/vascular-pathology\/"},{"@type":"ListItem","position":5,"name":"Inflammatory vascular diseases","item":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/vascular-pathology\/inflammatory-vascular-diseases\/"},{"@type":"ListItem","position":6,"name":"Vasculitides"}]},{"@type":"WebSite","@id":"https:\/\/meddists.com\/learn\/#website","url":"https:\/\/meddists.com\/learn\/","name":"Meddists","description":"Let&#039;s Get Studying","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/meddists.com\/learn\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/8082","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/comments?post=8082"}],"version-history":[{"count":3,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/8082\/revisions"}],"predecessor-version":[{"id":9465,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/8082\/revisions\/9465"}],"up":[{"embeddable":true,"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/pages\/8079"}],"wp:attachment":[{"href":"https:\/\/meddists.com\/learn\/wp-json\/wp\/v2\/media?parent=8082"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}