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• Characterised by Inflammation and damage
to blood vessels.
• Vessel lumen is usually compromised .
• Leads to ishemia of...
 Vasculitis may be primary-
I. The primary vasculitis syndromes.
 It may be secondary to
1. Infections(Rickettsia, Neiss...
 Immune complex formation and/or
deposition

 Anti Neutrophil Cytoplasmic Antibodies
production.(ANCA)

 T lymphocyte...
 Immune complexes get deposited in vessel wall
 Activation of Complement components (C5a which is
strongly chemotactic f...
 Many patients with active vasculitis do not
have demonstrable circulating or deposited
immune complexes
 The Antigens p...
 Henoch Shonlein purpura.
 Polyarteritis Nodosa( Hepatitis B Ag-Ab)
 Collagen vascular diseases(SLE, Rheumatoid
Arthrit...
 Antibodies against certain protiens in the
cytoplasmic granules of neutrophils and monocytes
are present in the serum of...
 Either ANCA may be present in any of the
ANCA associated vasculitides.
 c ANCA is typically seen in
Wegners granulamato...
 Patients may have Wegners granulamatosis
with polyangitis in the absence of ANCA
 Titer of antibodies does not correlat...
 Endothelial cells may express HLA II
molecules at their surface similar to antigen
presenting cells. ( following activat...
 Giant Cell (Temporal)Artritis
 Takayashus Arteritis
 Wegners Granulamatosis
 Churg- Strauss Syndrome.
 In Kawasaki disease (Mucocutaneous Lymph
Node syndrome), 25% cases are associated
with coronary artery aneurism.
 Vascu...
Vasculitis pathology
Vasculitis pathology
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Vasculitis pathology

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Brief description of the pathology of vasculitis.

Published in: Health & Medicine, Technology
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Vasculitis pathology

  1. 1. • Characterised by Inflammation and damage to blood vessels. • Vessel lumen is usually compromised . • Leads to ishemia of the tissues supplied. • It may involve a single organ(skin) or it may involve multiple organs.
  2. 2.  Vasculitis may be primary- I. The primary vasculitis syndromes.  It may be secondary to 1. Infections(Rickettsia, Neisseria,Syphilis, Varicella) 2. Other Autoimmune diseases(SLE, Rheum. Arthritis) 3. Malignancy
  3. 3.  Immune complex formation and/or deposition   Anti Neutrophil Cytoplasmic Antibodies production.(ANCA)   T lymphocyte activation with granuloma formation   Direct Antibody mediated.
  4. 4.  Immune complexes get deposited in vessel wall  Activation of Complement components (C5a which is strongly chemotactic for neutrophils)  Neutrophils phagocytose immune complexes and release their intracytoplasmic enzymes that damage the vessel wall.  As the process becomes sub acute or chronic, mononuclear cells infiltrate the vessel wall.
  5. 5.  Many patients with active vasculitis do not have demonstrable circulating or deposited immune complexes  The Antigens present in the complexes are rarely identified.  Exeptions are most cases of PAN (hepatitis B antigen) and Cryoglobulinemic vasculitis (Hepatitis C antigen)  So the causal role of immune complexes has not been established in most of the vasculitis syndromes.
  6. 6.  Henoch Shonlein purpura.  Polyarteritis Nodosa( Hepatitis B Ag-Ab)  Collagen vascular diseases(SLE, Rheumatoid Arthrits)  Cryoglobulinemic vasculitis.(Hepatitis C Ag- Ab)  Serum sickness.
  7. 7.  Antibodies against certain protiens in the cytoplasmic granules of neutrophils and monocytes are present in the serum of certain patients with vasculitis.  These are the ANCA associated vasculitis syndromes.  cANCA is directed against cytoplasmic protienase 3  p ANCA is directed against perinuclear myeloperoxidase.
  8. 8.  Either ANCA may be present in any of the ANCA associated vasculitides.  c ANCA is typically seen in Wegners granulamatosis with polyangitis(90%)  p ANCA is seen in most cases of Microscopic polyangitis and Churg Strauss Syndrome.
  9. 9.  Patients may have Wegners granulamatosis with polyangitis in the absence of ANCA  Titer of antibodies does not correlate with disease severity.  Patients who are in remission from Wegners may continue to have high cANCA titers.  Thus the role of these auto antibodies in pathogenesis of systemic vasculitis remains unclear.
  10. 10.  Endothelial cells may express HLA II molecules at their surface similar to antigen presenting cells. ( following activation by cytokines)  CD4+ T cells get activated following interaction with these endothelial cells.  Propogation of immunological processes resulting in cell mediated injury, granuloma formation, delayed hypersensitivity.
  11. 11.  Giant Cell (Temporal)Artritis  Takayashus Arteritis  Wegners Granulamatosis  Churg- Strauss Syndrome.
  12. 12.  In Kawasaki disease (Mucocutaneous Lymph Node syndrome), 25% cases are associated with coronary artery aneurism.  Vasculitis of the coronary arteries are found in virtually all cases that had been autopsied.  Anti- Endothelial Cell antibodies are believed to play the central role.

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