LONDON—Despite the detailed terminology for describing vasculitis established by the Chapel Hill Consensus (CHC) in 2012, the field badly needs better classification and diagnostic criteria for the group of diseases, an expert said in a presentation at the Annual Congress of the European League Against Rheumatism (EULAR 2016). It’s a topic that is now being…
CHICAGO—Diagnosing and treating IgA vasculitis—leukocytoclastic vasculitis involving deposits of IgA1 deposits on the walls of small vessels—is rife with uncertainties, outright unknowns and treatment challenges, an expert on the disease said at the ACR’s 2016 State-of-the-Art Clinical Symposium. Alexandra Villa-Forte, MD, MPH, staff physician at Cleveland Clinic’s Center for Vasculitis Care and Research, said IgA…
SAN FRANCISCO—The heterogeneity of systemic vasculitis, a set of diseases characterized by inflammation of blood vessel walls, presents rheumatologists with diagnostic and treatment challenges, said Sharon A. Chung, MD, MAS, director of the University of California, San Francisco Vasculitis Clinic, at the California Rheumatology Alliance 2016 Scientific & Medical Meeting in May. She outlined emerging…
A variety of immune and nonimmune pathophysiologic mechanisms causing the disruption of alveolar capillaries with bleeding into the alveolar spaces can lead to diffuse alveolar hemorrhage (DAH). Immune-mediated mechanisms can cause DAH with or without the presence of capillaritis. The antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) syndromes—granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA)—are the…
SAN FRANCISCO—Behçet’s disease is a vasculitis that can be hard to pin down, with a wide variety of manifestations, many of which overlap with other auto-inflammatory conditions, an expert said at a clinical review course at the 2015 ACR/ARHP Annual Meeting. The most common feature is oral ulcers, which are expected to be seen at…
SAN FRANCISCO—Let’s say your radiologist comes to you and says that an angiogram gives a diagnosis of CNS vasculitis on four patients, all with acute onset of headache and stroke: One is a 25-year-old woman who is three months pregnant. Another is a 50-year-old man using excessive doses of nasal decongestants. Another is a 40-year-old…
Case report: A 27-year-old male was referred to the rheumatology outpatient department in February 2015 from the urology department after complaining of recent-onset uncontrolled hypertension (220/160 mmHg), headache and vomiting. In 2010, he was admitted to the urologist for sudden-onset left lumbar region pain and recent-onset hypertension. Clinical examination and the blood tests were normal….
New research recommends that doctors test the sera of patients with idiopathic pulmonary fibrosis for anti-neutrophil cytoplasmic antibodies (ANCA), as well as closely monitor this population for signs of lung vasculitis…
Case report: A 60-year-old Hispanic male with poorly controlled hypertension was sent from the primary care clinic for evaluation of malignant hypertension with a systolic blood pressure above 200 mmHg. His symptoms at the time of presentation included episodic confusion, worsening vision and an unsteady gait. A head computed tomography (CT) scan showed a subacute…
Temporal arteritis was first described by Sir Jonathan Hutchinson in 1890 in an elderly retired gentleman’s servant who developed red, painful streaks on his temples and was found to have bilaterally swollen temporal arteries with feeble pulses.1 Sir Hutchinson disputed the suggestion that the red streaks were caused by the man’s hat and, instead, called…