Vasculitis refers to inflammation of blood vessels. There are many types classified by the size of vessels involved and pathogenic mechanisms. Noninfectious vasculitis can be immune complex-mediated, associated with ANCAs, anti-endothelial cell antibodies, or autoreactive T cells. Infectious vasculitis involves direct invasion of vessels by pathogens. Common noninfectious vasculitides include giant cell arteritis, Takayasu arteritis, polyarteritis nodosa, Kawasaki disease, microscopic polyangiitis, Wegener's granulomatosis, Churg-Strauss syndrome, and Buerger's disease. Clinical manifestations depend on the organs involved. Treatment involves immunos
This document discusses vasculitis, including its classification, symptoms, and mimickers. Vasculitis is characterized by inflammation of blood vessels that can lead to ischemia. It is classified as either primary, where vasculitis is the principal feature, or secondary, where it is associated with another condition. Primary vasculitis is further divided based on vessel size affected. Symptoms depend on the vessel size involved and can include limb pain, rashes, organ dysfunction. Secondary causes include drugs, infections like hepatitis, and rheumatologic diseases. The document outlines features of different types and emphasizes vasculitis must be differentiated from conditions that can mimic its presentation.
Vasculitis refers to inflammation of blood vessels. It can be caused by direct infection, immune complexes, or antibodies. Types include large vessel vasculitis like giant cell arteritis, medium vessel vasculitis like polyarteritis nodosa, and small vessel vasculitis like Wegener's granulomatosis. Giant cell arteritis most commonly affects those over 50 and causes headaches, vision loss, and temporal artery inflammation. Polyarteritis nodosa involves small and medium arteries and can cause fever, weight loss, and kidney involvement. Wegener's granulomatosis is characterized by lung and respiratory tract inflammation and kidney disease.
Polyarteritis nodosa is a rare systemic necrotizing vasculitis that causes inflammation of small and medium-sized arteries. It is characterized by lesions that form at arterial bifurcations, causing aneurysms, thrombosis, ischemia, and organ damage. While its cause is unknown, it has been linked to hepatitis B virus infection. Symptoms can affect many organ systems and include fever, weight loss, skin lesions, neuropathy, gastrointestinal involvement, and renal impairment. Diagnosis involves meeting 3 out of 10 American College of Rheumatology criteria and treatment focuses on immunosuppression with corticosteroids and cyclophosphamide. Prognosis depends on organ involvement but outcomes have improved with aggressive immunosuppressive therapy.
Vasculitis refers to a group of diseases characterized by inflammation of blood vessels. The document defines and classifies different types of vasculitis based on vessel size. It discusses the pathophysiology, clinical features, investigations and management of vasculitis. Giant cell arteritis is provided as an example of large vessel vasculitis that predominantly affects branches of the temporal and ophthalmic arteries in older individuals, with headaches, jaw pain and risk of vision loss as key clinical features.
This document discusses various types of vasculitis and their ocular manifestations. It begins by describing the typical presentations of ocular vasculitis such as decreased vision, floaters, and scotomata. Imaging findings on fluorescein angiography and optical coherence tomography are also summarized. The document then differentiates between primary ocular vasculitis, secondary ocular vasculitis, and systemic vasculitis involving the eye. Specific conditions are outlined including Eale's disease, giant cell arteritis, Wegener's granulomatosis, and lupus retinopathy. Treatment options are briefly mentioned for some conditions.
Approach to a patient with vasculitis and itsMohit Aggarwal
Vasculitis refers to inflammation of blood vessels. It can be primary or secondary to other conditions like drugs, infections, collagen disorders or malignancies. It involves various sizes of blood vessels from large arteries to small vessels. Common symptoms include fever, fatigue, rashes, arthritis, and organ involvement depending on the vessel type. Diagnosis is based on clinical features, lab tests like ANCA, and biopsy. Treatment involves immunosuppression. Prognosis depends on type and organ involvement.
Vasculitis refers to inflammation of blood vessels. There are many types classified by the size of vessels involved and pathogenic mechanisms. Noninfectious vasculitis can be immune complex-mediated, associated with ANCAs, anti-endothelial cell antibodies, or autoreactive T cells. Infectious vasculitis involves direct invasion of vessels by pathogens. Common noninfectious vasculitides include giant cell arteritis, Takayasu arteritis, polyarteritis nodosa, Kawasaki disease, microscopic polyangiitis, Wegener's granulomatosis, Churg-Strauss syndrome, and Buerger's disease. Clinical manifestations depend on the organs involved. Treatment involves immunos
This document discusses vasculitis, including its classification, symptoms, and mimickers. Vasculitis is characterized by inflammation of blood vessels that can lead to ischemia. It is classified as either primary, where vasculitis is the principal feature, or secondary, where it is associated with another condition. Primary vasculitis is further divided based on vessel size affected. Symptoms depend on the vessel size involved and can include limb pain, rashes, organ dysfunction. Secondary causes include drugs, infections like hepatitis, and rheumatologic diseases. The document outlines features of different types and emphasizes vasculitis must be differentiated from conditions that can mimic its presentation.
Vasculitis refers to inflammation of blood vessels. It can be caused by direct infection, immune complexes, or antibodies. Types include large vessel vasculitis like giant cell arteritis, medium vessel vasculitis like polyarteritis nodosa, and small vessel vasculitis like Wegener's granulomatosis. Giant cell arteritis most commonly affects those over 50 and causes headaches, vision loss, and temporal artery inflammation. Polyarteritis nodosa involves small and medium arteries and can cause fever, weight loss, and kidney involvement. Wegener's granulomatosis is characterized by lung and respiratory tract inflammation and kidney disease.
Polyarteritis nodosa is a rare systemic necrotizing vasculitis that causes inflammation of small and medium-sized arteries. It is characterized by lesions that form at arterial bifurcations, causing aneurysms, thrombosis, ischemia, and organ damage. While its cause is unknown, it has been linked to hepatitis B virus infection. Symptoms can affect many organ systems and include fever, weight loss, skin lesions, neuropathy, gastrointestinal involvement, and renal impairment. Diagnosis involves meeting 3 out of 10 American College of Rheumatology criteria and treatment focuses on immunosuppression with corticosteroids and cyclophosphamide. Prognosis depends on organ involvement but outcomes have improved with aggressive immunosuppressive therapy.
Vasculitis refers to a group of diseases characterized by inflammation of blood vessels. The document defines and classifies different types of vasculitis based on vessel size. It discusses the pathophysiology, clinical features, investigations and management of vasculitis. Giant cell arteritis is provided as an example of large vessel vasculitis that predominantly affects branches of the temporal and ophthalmic arteries in older individuals, with headaches, jaw pain and risk of vision loss as key clinical features.
This document discusses various types of vasculitis and their ocular manifestations. It begins by describing the typical presentations of ocular vasculitis such as decreased vision, floaters, and scotomata. Imaging findings on fluorescein angiography and optical coherence tomography are also summarized. The document then differentiates between primary ocular vasculitis, secondary ocular vasculitis, and systemic vasculitis involving the eye. Specific conditions are outlined including Eale's disease, giant cell arteritis, Wegener's granulomatosis, and lupus retinopathy. Treatment options are briefly mentioned for some conditions.
Approach to a patient with vasculitis and itsMohit Aggarwal
Vasculitis refers to inflammation of blood vessels. It can be primary or secondary to other conditions like drugs, infections, collagen disorders or malignancies. It involves various sizes of blood vessels from large arteries to small vessels. Common symptoms include fever, fatigue, rashes, arthritis, and organ involvement depending on the vessel type. Diagnosis is based on clinical features, lab tests like ANCA, and biopsy. Treatment involves immunosuppression. Prognosis depends on type and organ involvement.
This document defines and describes different types of vasculitis. It begins by defining vasculitis as inflammation of blood vessel walls. The two main ways of classifying vasculitides are by the size of blood vessels involved and the presence or absence of ANCA. Small vessel vasculitis can be ANCA-positive (e.g. Wegener's granulomatosis, Churg-Strauss syndrome) or ANCA-negative (e.g. Henoch-Schönlein purpura). Medium vessel vasculitides include polyarteritis nodosa and Kawasaki's disease. Large vessel vasculitides include giant cell arteritis, Takayasaki's disease, and poly
1. Vasculitis is defined as inflammation of blood vessel walls and can be classified by the size of vessels involved - large, medium, or small.
2. Some examples of large vessel vasculitis include giant-cell arteritis, which commonly involves the temporal artery in older patients, and Takayasu arteritis, which usually occurs in younger patients.
3. Medium vessel vasculitis encompasses diseases like polyarteritis nodosa, characterized by necrotizing inflammation of renal arteries, and Kawasaki disease, an arteritis that can cause coronary aneurysms in children.
4. Small vessel vasculitis includes Wegener's granulomatosis, Churg-Stra
This document discusses several types of vasculitis:
- Wegener's granulomatosis is a necrotizing vasculitis that commonly affects the lungs and kidneys. It is associated with cytoplasmic ANCA and affects small vessels.
- Microscopic polyangiitis is a pauci-immune vasculitis mainly involving small vessels. It commonly causes glomerulonephritis and pulmonary capillaritis.
- Churg-Strauss syndrome is characterized by asthma, eosinophilia, and vasculitis affecting multiple organ systems. It is associated with perinuclear ANCA.
This document provides an overview of vasculitis, including:
1) Vasculitis is inflammation and necrosis of blood vessels that can lead to occlusion, ischemia, and multi-system organ dysfunction.
2) It is classified based on the size of affected vessels as well as the organ systems involved.
3) Diagnosis involves determining which organ systems are affected, excluding other potential causes, and obtaining biopsies of involved tissues when possible. Laboratory tests including ANCA can also provide clues to diagnosis.
Vasculitis refers to inflammation of blood vessels. This document discusses the classification, pathogenesis, and syndromes of vasculitis. It is difficult to classify vasculitis due to overlapping features and unknown causes. The Chapel Hill system divides vasculitis by vessel size. Mechanisms include immune complex formation, ANCA production, and T-cell responses. Large vessel vasculitis includes giant cell arteritis and Takayasu arteritis. Giant cell arteritis causes headaches and vision loss. Treatment is glucocorticoids. Takayasu arteritis causes reduced pulses and organ ischemia, especially in young Asian women. Both can lead to complications like aneurysms if untreated.
This document provides an overview of vasculitis, including classification, pathophysiology, clinical manifestations, investigations, and management approaches. It discusses several specific large vessel vasculitides - giant cell arteritis, Takayasu arteritis, and polyarteritis nodosa. Giant cell arteritis commonly involves temporal arteries and causes headaches. Takayasu arteritis primarily affects the aorta and its branches. Polyarteritis nodosa preferentially involves the skin, nerves, gastrointestinal tract and kidneys. Diagnosis relies on tissue biopsy and imaging. Treatment focuses on glucocorticoids, with additional immunosuppressants for severe or refractory disease.
Vasculitis refers to inflammation of blood vessels which can be cutaneous or systemic. It is characterized by destruction of vessel walls by leukocytes leading to ischemia and tissue damage. It can be triggered by infections, medications, or underlying diseases. Classification systems categorize vasculitis based on vessel size. Common types include hypersensitivity vasculitis, cutaneous leukocytoclastic vasculitis, Henoch-Schonlein purpura, urticarial vasculitis, and erythema elevatum diutinum. Pathogenesis involves immune complex deposition, antineutrophil cytoplasmic antibodies, and cellular immune responses.
Systematization and diagnosis of vasculitides. Mikhail ValivachMikhail Valivach
This document provides an overview of the systematization and diagnosis of vasculitides. It discusses that vasculitides can be primary or secondary, and focuses on primary vasculitides. The key factors in diagnosing and classifying primary vasculitides are the size of affected vessels, the primary pathogenic mechanisms (such as immune complexes, ANCA, or anti-GBM antibodies), the type of secondary inflammatory reaction (granulomatous or eosinophilic), the distribution of affected organs, and the severity of vascular damage. Histology through biopsy is important for diagnosis, showing features like angiocentric inflammatory infiltration and vascular wall damage. Different classification systems are used, including the Chapel Hill definitions.
This document discusses vasculitis, which is inflammation of blood vessels. It defines vasculitis and describes the different types including large vessel, medium vessel, and small vessel vasculitis. Specific conditions are discussed such as giant cell arteritis, granulomatosis with polyangiitis, Churg-Strauss syndrome, Behcet's disease, thromboangiitis obliterans, and infectious vasculitis. The pathology, clinical features, morphology, and treatment of some of these conditions are summarized. Images are also included showing histological features.
Vasculitis is a condition characterized by inflammation and damage to blood vessels. There are several types of vasculitis classified by the size of vessels affected (large, medium, small). Imaging plays an important role in the diagnosis and monitoring of vasculitis by detecting vessel wall abnormalities and inflammation before lumen changes occur on angiography. Techniques like CT angiography, MRI, MRA, and PET are useful for revealing vessel wall alterations and inflammation. The choice of imaging depends on the suspected organ involvement.
This document discusses vasculitis, which is inflammation of blood vessels. It classifies vasculitis into large, medium, and small vessel types and discusses specific conditions like temporal arteritis, Takayasu arteritis, polyarteritis nodosa, Henoch-Schönlein purpura, Behcet's disease, Wegener's granulomatosis, microscopic polyangiitis, and Churg-Strauss syndrome. For each condition, it covers clinical manifestations, diagnosis, and treatment. Vasculitis can affect multiple organ systems and cause symptoms like fever, skin lesions, neurological issues, and kidney problems. Diagnosis involves tests like biopsy and ANCA levels while treatment consists of steroids, immunosup
This document provides an overview of vasculitis, including:
- Vasculitis refers to inflammation of blood vessel walls and can range from mild to life-threatening.
- It encompasses a large group of diseases characterized by inflammatory reactions in blood vessel walls. The causes are often unknown but can be triggered by various stimuli.
- Diagnosis involves blood tests, biopsies of affected tissues like skin and kidneys, and imaging tests. Biopsies examined under a microscope are often needed to confirm a diagnosis of vasculitis.
Vasculitis refers to inflammation of blood vessels. This document discusses vasculitis syndromes including definitions, classifications, clinical presentations, diagnostic evaluations, and management. Vasculitides are classified based on the size of vessels predominantly involved as large, medium, or small vessel. Common small vessel vasculitis includes Wegener's granulomatosis and microscopic polyangiitis. Treatment involves immunosuppressants such as cyclophosphamide, steroids, methotrexate, and biologics depending on severity and type of vasculitis. Prompt diagnosis and treatment is important to prevent organ damage from ischemia.
Vasculitis refers to inflammation of blood vessels. The document discusses the classification, pathogenesis, clinical manifestations, investigations, and histopathology of various types of vasculitis. It classifies vasculitis based on vessel size (large, medium, small vessel) and cause (primary, secondary to infection, drugs, etc). Pathogenesis may involve infectious or non-infectious mechanisms like immune complex deposition, ANCA, or anti-endothelial cell antibodies. Investigations assess organ damage, immune mechanisms, and provide tissue diagnosis. Clinical features and histopathology vary depending on the type and organs involved in the vasculitis.
Vasculitis refers to inflammation of blood vessels. This document discusses the approach to diagnosing and classifying different types of vasculitis. It describes:
1) The pathological changes in vasculitis which include thinning of vessel walls and narrowing/occlusion of affected vessels.
2) The different mechanisms that can cause vasculitis including immune complex formation, ANCA mediated, and T lymphocyte mediated responses.
3) How to classify vasculitis into primary disorders or those secondary to other medical conditions. Primary vasculitis are further broken down by vessel size affected.
4) The steps involved in evaluating a patient with suspected vasculitis which includes screening for mimics, assessing organ involvement
This document provides an overview of vasculitis, including definitions, common clinical features, pathogenic mechanisms, classification, and morphology for several specific types of vasculitis. It defines vasculitis as inflammation of blood vessels that can affect small, medium, and large vessels. Common symptoms include fever, arthralgia, myalgia, fatigue, and purpura. Pathogenic mechanisms include immune-mediated inflammation in non-infectious vasculitis and direct vascular insult by infectious pathogens in infectious vasculitis. Specific types discussed include temporal arteritis/giant cell arteritis, Takayasu arteritis, Kawasaki disease, Buerger disease, polyarteritis nodosa, and Wegener granulo
This document provides an overview of vasculitis in children. It defines vasculitis as an inflammatory destructive process affecting arteries and veins. It discusses the pathogenesis, classification, pathology, clinical features, diagnosis, and treatment of various types of vasculitis in children. The document focuses on defining different types of vasculitis based on the size of blood vessels involved, location of lesions, and pathology. It provides details on the clinical presentation and organ system involvement of conditions like Henoch-Schönlein purpura, Kawasaki disease, polyarteritis nodosa, Wegener's granulomatosis, and Churg-Strauss syndrome. Criteria for diagnosing some common pediatric vasculitides are
This document provides an overview of updates in the diagnosis and management of vasculitis. It begins with basic facts about vasculitis and its classification. It then discusses patient perspectives on living with vasculitis and treatments including glucocorticoids, cyclophosphamide, methotrexate, azathioprine, and newer therapies like rituximab. Evidence-based recommendations from EULAR are also summarized that provide guidance on conducting clinical studies, assessing disease activity, and treatment approaches for different types of vasculitis.
Vasculitis syndrome an approach -and-basic principles of treatmentSachin Verma
Vasculitides are a hetrogenous group of conditions characterized by inflammation and necrosis of blood vessels.
A broad group of syndromes may result from this process,since any type,size, and location of vessel may be involved.
1. The lecture covers the definition, pathophysiology, classification, clinical presentation, diagnosis and treatment of various types of vasculitis.
2. Vasculitis is classified according to the size of blood vessels involved, ranging from large vessel vasculitis like Takayasu arteritis and Giant Cell Arteritis, to medium vessel vasculitis like Polyarteritis nodosa, to small vessel vasculitis like Wegener's granulomatosis.
3. Key aspects of evaluation include clinical features, laboratory and serological testing, imaging, and biopsy. Management involves treatment of underlying causes, immunosuppression, and controlling disease activity and complications.
This document discusses the approach to gastrointestinal bleeding. It begins by describing the clinical presentations of GI bleeding and how to assess the severity. Resuscitation is proportional to bleeding severity. The history, physical exam, and diagnostic tests are discussed. Common and less frequent causes of upper GI bleeding are outlined. Treatment depends on the cause, with endoscopic therapy and pharmacologic agents used for bleeding peptic ulcers and varices.
This document defines and describes different types of vasculitis. It begins by defining vasculitis as inflammation of blood vessel walls. The two main ways of classifying vasculitides are by the size of blood vessels involved and the presence or absence of ANCA. Small vessel vasculitis can be ANCA-positive (e.g. Wegener's granulomatosis, Churg-Strauss syndrome) or ANCA-negative (e.g. Henoch-Schönlein purpura). Medium vessel vasculitides include polyarteritis nodosa and Kawasaki's disease. Large vessel vasculitides include giant cell arteritis, Takayasaki's disease, and poly
1. Vasculitis is defined as inflammation of blood vessel walls and can be classified by the size of vessels involved - large, medium, or small.
2. Some examples of large vessel vasculitis include giant-cell arteritis, which commonly involves the temporal artery in older patients, and Takayasu arteritis, which usually occurs in younger patients.
3. Medium vessel vasculitis encompasses diseases like polyarteritis nodosa, characterized by necrotizing inflammation of renal arteries, and Kawasaki disease, an arteritis that can cause coronary aneurysms in children.
4. Small vessel vasculitis includes Wegener's granulomatosis, Churg-Stra
This document discusses several types of vasculitis:
- Wegener's granulomatosis is a necrotizing vasculitis that commonly affects the lungs and kidneys. It is associated with cytoplasmic ANCA and affects small vessels.
- Microscopic polyangiitis is a pauci-immune vasculitis mainly involving small vessels. It commonly causes glomerulonephritis and pulmonary capillaritis.
- Churg-Strauss syndrome is characterized by asthma, eosinophilia, and vasculitis affecting multiple organ systems. It is associated with perinuclear ANCA.
This document provides an overview of vasculitis, including:
1) Vasculitis is inflammation and necrosis of blood vessels that can lead to occlusion, ischemia, and multi-system organ dysfunction.
2) It is classified based on the size of affected vessels as well as the organ systems involved.
3) Diagnosis involves determining which organ systems are affected, excluding other potential causes, and obtaining biopsies of involved tissues when possible. Laboratory tests including ANCA can also provide clues to diagnosis.
Vasculitis refers to inflammation of blood vessels. This document discusses the classification, pathogenesis, and syndromes of vasculitis. It is difficult to classify vasculitis due to overlapping features and unknown causes. The Chapel Hill system divides vasculitis by vessel size. Mechanisms include immune complex formation, ANCA production, and T-cell responses. Large vessel vasculitis includes giant cell arteritis and Takayasu arteritis. Giant cell arteritis causes headaches and vision loss. Treatment is glucocorticoids. Takayasu arteritis causes reduced pulses and organ ischemia, especially in young Asian women. Both can lead to complications like aneurysms if untreated.
This document provides an overview of vasculitis, including classification, pathophysiology, clinical manifestations, investigations, and management approaches. It discusses several specific large vessel vasculitides - giant cell arteritis, Takayasu arteritis, and polyarteritis nodosa. Giant cell arteritis commonly involves temporal arteries and causes headaches. Takayasu arteritis primarily affects the aorta and its branches. Polyarteritis nodosa preferentially involves the skin, nerves, gastrointestinal tract and kidneys. Diagnosis relies on tissue biopsy and imaging. Treatment focuses on glucocorticoids, with additional immunosuppressants for severe or refractory disease.
Vasculitis refers to inflammation of blood vessels which can be cutaneous or systemic. It is characterized by destruction of vessel walls by leukocytes leading to ischemia and tissue damage. It can be triggered by infections, medications, or underlying diseases. Classification systems categorize vasculitis based on vessel size. Common types include hypersensitivity vasculitis, cutaneous leukocytoclastic vasculitis, Henoch-Schonlein purpura, urticarial vasculitis, and erythema elevatum diutinum. Pathogenesis involves immune complex deposition, antineutrophil cytoplasmic antibodies, and cellular immune responses.
Systematization and diagnosis of vasculitides. Mikhail ValivachMikhail Valivach
This document provides an overview of the systematization and diagnosis of vasculitides. It discusses that vasculitides can be primary or secondary, and focuses on primary vasculitides. The key factors in diagnosing and classifying primary vasculitides are the size of affected vessels, the primary pathogenic mechanisms (such as immune complexes, ANCA, or anti-GBM antibodies), the type of secondary inflammatory reaction (granulomatous or eosinophilic), the distribution of affected organs, and the severity of vascular damage. Histology through biopsy is important for diagnosis, showing features like angiocentric inflammatory infiltration and vascular wall damage. Different classification systems are used, including the Chapel Hill definitions.
This document discusses vasculitis, which is inflammation of blood vessels. It defines vasculitis and describes the different types including large vessel, medium vessel, and small vessel vasculitis. Specific conditions are discussed such as giant cell arteritis, granulomatosis with polyangiitis, Churg-Strauss syndrome, Behcet's disease, thromboangiitis obliterans, and infectious vasculitis. The pathology, clinical features, morphology, and treatment of some of these conditions are summarized. Images are also included showing histological features.
Vasculitis is a condition characterized by inflammation and damage to blood vessels. There are several types of vasculitis classified by the size of vessels affected (large, medium, small). Imaging plays an important role in the diagnosis and monitoring of vasculitis by detecting vessel wall abnormalities and inflammation before lumen changes occur on angiography. Techniques like CT angiography, MRI, MRA, and PET are useful for revealing vessel wall alterations and inflammation. The choice of imaging depends on the suspected organ involvement.
This document discusses vasculitis, which is inflammation of blood vessels. It classifies vasculitis into large, medium, and small vessel types and discusses specific conditions like temporal arteritis, Takayasu arteritis, polyarteritis nodosa, Henoch-Schönlein purpura, Behcet's disease, Wegener's granulomatosis, microscopic polyangiitis, and Churg-Strauss syndrome. For each condition, it covers clinical manifestations, diagnosis, and treatment. Vasculitis can affect multiple organ systems and cause symptoms like fever, skin lesions, neurological issues, and kidney problems. Diagnosis involves tests like biopsy and ANCA levels while treatment consists of steroids, immunosup
This document provides an overview of vasculitis, including:
- Vasculitis refers to inflammation of blood vessel walls and can range from mild to life-threatening.
- It encompasses a large group of diseases characterized by inflammatory reactions in blood vessel walls. The causes are often unknown but can be triggered by various stimuli.
- Diagnosis involves blood tests, biopsies of affected tissues like skin and kidneys, and imaging tests. Biopsies examined under a microscope are often needed to confirm a diagnosis of vasculitis.
Vasculitis refers to inflammation of blood vessels. This document discusses vasculitis syndromes including definitions, classifications, clinical presentations, diagnostic evaluations, and management. Vasculitides are classified based on the size of vessels predominantly involved as large, medium, or small vessel. Common small vessel vasculitis includes Wegener's granulomatosis and microscopic polyangiitis. Treatment involves immunosuppressants such as cyclophosphamide, steroids, methotrexate, and biologics depending on severity and type of vasculitis. Prompt diagnosis and treatment is important to prevent organ damage from ischemia.
Vasculitis refers to inflammation of blood vessels. The document discusses the classification, pathogenesis, clinical manifestations, investigations, and histopathology of various types of vasculitis. It classifies vasculitis based on vessel size (large, medium, small vessel) and cause (primary, secondary to infection, drugs, etc). Pathogenesis may involve infectious or non-infectious mechanisms like immune complex deposition, ANCA, or anti-endothelial cell antibodies. Investigations assess organ damage, immune mechanisms, and provide tissue diagnosis. Clinical features and histopathology vary depending on the type and organs involved in the vasculitis.
Vasculitis refers to inflammation of blood vessels. This document discusses the approach to diagnosing and classifying different types of vasculitis. It describes:
1) The pathological changes in vasculitis which include thinning of vessel walls and narrowing/occlusion of affected vessels.
2) The different mechanisms that can cause vasculitis including immune complex formation, ANCA mediated, and T lymphocyte mediated responses.
3) How to classify vasculitis into primary disorders or those secondary to other medical conditions. Primary vasculitis are further broken down by vessel size affected.
4) The steps involved in evaluating a patient with suspected vasculitis which includes screening for mimics, assessing organ involvement
This document provides an overview of vasculitis, including definitions, common clinical features, pathogenic mechanisms, classification, and morphology for several specific types of vasculitis. It defines vasculitis as inflammation of blood vessels that can affect small, medium, and large vessels. Common symptoms include fever, arthralgia, myalgia, fatigue, and purpura. Pathogenic mechanisms include immune-mediated inflammation in non-infectious vasculitis and direct vascular insult by infectious pathogens in infectious vasculitis. Specific types discussed include temporal arteritis/giant cell arteritis, Takayasu arteritis, Kawasaki disease, Buerger disease, polyarteritis nodosa, and Wegener granulo
This document provides an overview of vasculitis in children. It defines vasculitis as an inflammatory destructive process affecting arteries and veins. It discusses the pathogenesis, classification, pathology, clinical features, diagnosis, and treatment of various types of vasculitis in children. The document focuses on defining different types of vasculitis based on the size of blood vessels involved, location of lesions, and pathology. It provides details on the clinical presentation and organ system involvement of conditions like Henoch-Schönlein purpura, Kawasaki disease, polyarteritis nodosa, Wegener's granulomatosis, and Churg-Strauss syndrome. Criteria for diagnosing some common pediatric vasculitides are
This document provides an overview of updates in the diagnosis and management of vasculitis. It begins with basic facts about vasculitis and its classification. It then discusses patient perspectives on living with vasculitis and treatments including glucocorticoids, cyclophosphamide, methotrexate, azathioprine, and newer therapies like rituximab. Evidence-based recommendations from EULAR are also summarized that provide guidance on conducting clinical studies, assessing disease activity, and treatment approaches for different types of vasculitis.
Vasculitis syndrome an approach -and-basic principles of treatmentSachin Verma
Vasculitides are a hetrogenous group of conditions characterized by inflammation and necrosis of blood vessels.
A broad group of syndromes may result from this process,since any type,size, and location of vessel may be involved.
1. The lecture covers the definition, pathophysiology, classification, clinical presentation, diagnosis and treatment of various types of vasculitis.
2. Vasculitis is classified according to the size of blood vessels involved, ranging from large vessel vasculitis like Takayasu arteritis and Giant Cell Arteritis, to medium vessel vasculitis like Polyarteritis nodosa, to small vessel vasculitis like Wegener's granulomatosis.
3. Key aspects of evaluation include clinical features, laboratory and serological testing, imaging, and biopsy. Management involves treatment of underlying causes, immunosuppression, and controlling disease activity and complications.
This document discusses the approach to gastrointestinal bleeding. It begins by describing the clinical presentations of GI bleeding and how to assess the severity. Resuscitation is proportional to bleeding severity. The history, physical exam, and diagnostic tests are discussed. Common and less frequent causes of upper GI bleeding are outlined. Treatment depends on the cause, with endoscopic therapy and pharmacologic agents used for bleeding peptic ulcers and varices.
Vasculitis refers to inflammation of blood vessels which can be primary or secondary. It presents in different ways depending on the age of onset and type, affecting various organs like skin, kidneys, lungs and eyes. Diagnosis involves assessing clinical features, labs, imaging and biopsy. Treatment focuses on inducing remission with steroids and immunosuppressants like cyclophosphamide. Maintenance involves steroids, azathioprine or biologics to prevent relapse while monitoring for complications. Outcomes have improved but morbidity and mortality remain high without treatment.
2. Glomerulonephritis & hypertension in children 01.04.15 lecture.pptxIvwananjisikombe1
Acute glomerulonephritis (AGN) is characterized by edema, hematuria, proteinuria, and hypertension resulting from inflammation of the glomeruli. It is commonly caused by a prior streptococcal infection. The inflammation damages renal tissue through immune complex deposition and cellular proliferation. Treatment focuses on controlling blood pressure and fluid balance. Medical management includes diuretics, ACE inhibitors, calcium channel blockers, and other antihypertensives. Outcomes are generally good if the inflammatory process is self-limited, but progressive kidney damage can occur if inflammation persists long-term.
This document discusses Kawasaki disease, a medium vessel vasculitis that presents as an acute febrile illness in children. It is a common pediatric disorder characterized by coronary artery anomalies in 15-25% of cases. The document covers the epidemiology, etiology, pathogenesis, clinical features, diagnostic criteria, management, and complications of Kawasaki disease. It provides details on diagnostic testing, treatment including intravenous immunoglobulin and aspirin, long term management of coronary abnormalities, and refractory cases.
Diagnosis, management, workup in a case of Takayasu's arteritis. Definition, synonyms, history, epidimiology, pathophysiology, etiology of Takayasu's arteritis.
Henoch-Schönlein purpura (HSP) is a vasculitis disorder typically seen in children that involves small vessel inflammation of the skin, gastrointestinal tract, kidneys, and joints. It is characterized by purpuric rash, abdominal pain, arthritis, and potential kidney involvement. While usually self-limiting, long term kidney damage can occur in some cases. Treatment focuses on symptom relief and monitoring for complications. Prognosis is generally good but recurrence and long term kidney issues are possible.
This document provides an outline of a lecture on upper gastrointestinal tract bleeding. It begins with definitions and discusses the epidemiology, causes, clinical presentation, diagnosis, treatment, complications, and prognosis of upper GI bleeding. The most common causes are bleeding peptic ulcers, erosive gastritis/esophagitis, and variceal bleeding from liver cirrhosis. The clinical presentation depends on features of blood loss and the underlying cause. Diagnosis involves history, physical exam, and investigations like blood tests, abdominal ultrasound, and upper endoscopy. Treatment involves resuscitation, transfusions, medications, and procedures depending on the identified cause. Complications can be from blood loss, treatment, or the underlying condition. Pro
This document discusses glomerulonephritis (GN), which is inflammation of the glomeruli in the kidneys. GN can be primary or associated with systemic disorders and is often immunologically mediated. It may present with hematuria, nephritic syndrome with oliguria and hypertension, or a mixed picture. Causes include post-infectious, IgA nephropathy, antiglomerular basement membrane antibody disease, and GN associated with conditions like SLE. Acute post-infectious GN typically occurs after streptococcal infection and presents with dark urine, puffy face, oliguria, and hypertension. Treatment involves monitoring and controlling blood pressure and fluid balance.
This document discusses glomerulonephritis (GN), which is inflammation of the glomeruli in the kidneys. It can occur as a primary condition or associated with other systemic disorders. The document covers the definition, etiology, pathogenesis, clinical features, investigations, and management of different types of GN including acute post-infectious GN, Henoch Schonlein purpura, and hemolytic uremic syndrome.
The document describes a case of a 55-year-old male patient presenting with breathlessness, palpitations, and fatigue for 1 year along with black sticky stools. Examinations revealed pallor and erythematous spots in the oral cavity. Investigations showed microcytic hypochromic anemia and occult blood in stool. Endoscopy revealed dilated vessels in the GI tract. CT angiogram showed abnormal vascular structures. The patient was diagnosed with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome) based on the presence of epistaxis, telangiectasias, GI bleeding, and family history.
EHPVO ( Extra Hepatic Portal Vein Obstruction)drmanojkurmana
This document provides an overview of extra-hepatic portal vein obstruction (EHPVO). It discusses the prevalence, etiology, clinical features, diagnosis, management, and prognosis of EHPVO. Key points include that EHPVO is characterized by obstruction of the portal vein outside the liver, it is more common in India than Western countries, causes include thrombosis and hypercoagulable states, clinical features include variceal bleeding and splenomegaly, management involves preventing complications through anticoagulation and procedures like TIPS, and prognosis depends on the underlying cause and presence of complications.
This document presents a case report of a 20-year-old female student who presented with abdominal distention, jaundice, and pain while urinating. Various tests were performed, including bloodwork, ultrasound, and biopsy. The final diagnosis was portal vein and splenic vein thrombosis due to a hypercoagulable state from essential thrombocythemia, exacerbated by oral contraceptive use. The document also reviews several other case reports and discusses vascular diseases of the liver like Budd-Chiari syndrome.
This document discusses systemic lupus erythematosus (SLE), an autoimmune disease where organs and cells are damaged by autoantibodies and immune complexes. It covers the etiology, pathogenesis, clinical manifestations, diagnosis, and management of SLE. Key points include that SLE affects multiple organ systems and has varied clinical presentations. Diagnosis is based on meeting 4 out of 11 American College of Rheumatology criteria including positive antinuclear antibodies and anti-dsDNA antibodies. Treatment involves managing symptoms across organ systems with medications like steroids, hydroxychloroquine, immunosuppressants, and targeting specific organ involvement. The goal is to control disease activity, prevent organ damage, and improve quality of life.
Upper gastrointestinal bleeding is a common medical condition that requires prompt assessment and treatment. Key steps in evaluation include determining hemodynamic stability, performing nasogastric aspiration to identify the source and activity of bleeding, and endoscopy within 24 hours of presentation to identify the cause and risk stratify patients. Resuscitation focuses on restoring circulating volume through blood transfusions and intravenous fluids while controlling active bleeding endoscopically. Risk stratification scores like Rockall and Blatchford are used to determine patient disposition and guide management.
This document discusses several diseases that present with hematuria or proteinuria in children. It describes a case of acute post-streptococcal glomerulonephritis in a 10-year-old boy presenting with edema and Coca-Cola colored urine. It then provides details on the etiology, clinical presentation, diagnosis, complications and treatment of this condition. It also summarizes several other conditions like IgA nephropathy, Alport syndrome, hemolytic uremic syndrome, polycystic kidney disease, nephrotic syndrome, undescended testes, testicular torsion, and epididymitis.
Approach to patients with upper gi bleedingRajesh S
This document provides an overview of a seminar on gastrointestinal bleeding. It begins with an introduction and outline. It then covers topics like the anatomy of the GI tract and sources of bleeding. Diagnostic assessments including history, exams, and tests are reviewed. Approaches to resuscitation, classification of shock, and fluid management are outlined. Etiologies of upper and lower GI bleeding like ulcers, varices, and tumors are summarized. Endoscopic and surgical management strategies are also discussed. Risk factors for poor prognosis with GI bleeding are listed. The document concludes with a risk score to predict need for intervention in GI bleeding cases.
This document discusses cardiovascular involvement in various collagen vascular disorders, including systemic lupus erythematosus (SLE). It notes that up to 70% of SLE patients show cardiovascular involvement upon autopsy or echocardiography. Common manifestations include pericardial disease, valvular disease, coronary artery disease, and myocardial disease. Pericarditis is the most common cardiovascular manifestation in SLE, occurring in 22-54% of patients. Valvular abnormalities like thickening and regurgitation are also common. The document further discusses cardiovascular involvement in other disorders like antiphospholipid antibody syndrome, systemic sclerosis, and drug-induced lupus.
This document discusses portal hypertension, its causes, signs, symptoms, diagnosis, and management. It provides an overview of normal portal circulation and defines portal hypertension as a portal pressure greater than 12 mmHg. It describes various etiologies of portal hypertension including presinusoidal, sinusoidal, postsinusoidal, and posthepatic causes. Complications of portal hypertension like variceal bleeding, ascites, and hepatic encephalopathy are discussed. The management of portal hypertension and its complications is also summarized.
Similar to Takayasu Arteritis, IgA Vasculitis ( Henoch Schonlein ) , Cryoglobulinemic vasculitis , Kawasaki Disease (20)
The document contains a 19-question quiz on gastroenterology. It covers topics like therapies for bleeding peptic ulcers, causes of unconjugated hyperbilirubinemia, morphological features of Crohn's disease, and the best approach for treating chronic diarrhea with opiate antidiarrheal drugs. The questions are multiple choice and cover a wide range of gastrointestinal diseases, presentations, investigations, and management strategies.
A 22-year-old male presented with a 14-day history of fever and right-sided chest pain that worsened with deep breathing and coughing. On examination, he was febrile and tachycardic with dullness on percussion of the right infraaxillary area and diminished breath sounds. The document discusses various pleural diseases including pneumothorax, pleural effusion, and fibrous pleurisy. It outlines their etiologies, clinical features, investigations, and management. Primary spontaneous pneumothorax commonly affects young, thin males and smokers due to rupture of subpleural blebs. Pleural effusions can be transudative such as in heart failure or exudative including those
This document provides information on the treatment of rheumatoid arthritis, including pharmacological and non-pharmacological options. It recommends initially treating with prednisolone and methotrexate, and if inadequate response adding additional disease-modifying antirheumatic drugs (DMARDs) like sulfasalazine, hydroxychloroquine, leflunomide, or azathioprine. It also discusses use of glucocorticoids, biologics like anti-TNF agents, the anti-IL-6 blocker tocilizumab, and notes non-pharmacological options like physical therapy and potential surgical interventions. The goal of treatment is to suppress inflammation, control symptoms, and prevent further joint
Sjogrens Syndrome - Clinical features, diagnosis and managementRohit Rajeevan
Venus Williams was admitted to the clinic suffering from dry eyes, dry mouth, dry skin, and enlarged parotid glands. Various tests confirmed she has Sjögren's syndrome, a systemic autoimmune disorder characterized by lymphocytic infiltration of exocrine glands resulting in sicca symptoms. Her positive SSA and SSB antibodies, low unstimulated salivary flow, positive biopsy, and other test results established the diagnosis of Sjögren's syndrome.
Osteroporosis - clinical features and managementRohit Rajeevan
Osteoporosis is defined as low bone mass and deterioration of bone tissue, leading to increased bone fragility and fracture risk. It is diagnosed based on bone mineral density measurements. Risk factors include older age, female sex, family history, smoking, excessive alcohol, low body weight, and medications like glucocorticoids. The disease results from an imbalance between bone resorption by osteoclasts and bone formation by osteoblasts. Treatment involves lifestyle modifications like calcium, vitamin D, and exercise as well as pharmacologic therapies such as bisphosphonates, SERMs, calcitonin, PTH, and strontium which reduce resorption or stimulate formation to increase bone mineral density and reduce fractures.
Osteoarthritis is a degenerative joint disease characterized by the breakdown of cartilage. It most commonly affects weight-bearing joints like the hips and knees. The cartilage, bone, synovial membrane, capsule, ligaments and muscles are all affected as the disease progresses. Symptoms include joint pain and stiffness that worsens with use of the affected joint. Treatment focuses on reducing pain and inflammation, maintaining joint mobility, and may include joint replacement surgery for severe cases.
Gout - Clinical features , diagnosis and managementRohit Rajeevan
Gout is a metabolic disease resulting from deposition of urate crystals in the joints and tissues. It was first identified by Egyptians in 2640 BC and described by Hippocrates. It predominantly affects men over age 40 and is associated with purine-rich foods and comorbidities like diabetes. Symptoms include recurrent acute inflammatory arthritis attacks, tophi formation, and chronic arthritis. Diagnosis involves synovial fluid analysis demonstrating urate crystals. Treatment includes NSAIDs, colchicine, urate-lowering drugs like allopurinol, and lifestyle modifications like diet and exercise. Pseudogout is caused by calcium pyrophosphate crystals and presents similarly but is diagnosed by demonstrating different crystals on syn
Behcets Syndrome is a multisystem disorder characterized by recurrent oral and genital ulcers. It predominantly affects young males and females and can cause ocular involvement leading to blindness. Pathophysiology involves systemic perivasculitis with endothelial inflammation. Clinical features include ulcers, skin lesions, eye involvement, arthritis, and thrombosis. Treatment involves topical steroids for ulcers, thalidomide for severe cases, aspirin for thrombosis, and systemic steroids and immunosuppressants like azathioprine for ocular and neurological involvement.
1. Systemic sclerosis is a disease characterized by abnormalities of blood vessels, fibrosis of skin and internal organs, and activation of the immune system.
2. It is classified as limited or diffuse cutaneous systemic sclerosis based on the extent of skin involvement and rate of progression.
3. Clinical features include Raynaud's phenomenon, skin thickening, joint and muscle involvement, as well as pulmonary, cardiac, gastrointestinal, and renal complications.
This document provides guidance on managing epilepsy in adults. It discusses when to initiate anti-seizure therapy such as after a first seizure based on risk factors. It also covers titrating medications, adding a second drug, and discontinuing drugs. The document recommends individualizing treatment based on seizure type, side effects, comorbidities, and patient preferences. It provides guidance on special populations including considerations for liver impairment, diabetes, blood disorders, women of childbearing age, pregnancy, and breastfeeding.
Rheumatoid arthritis most commonly affects the small joints of the hands and feet like the metacarpophalangeal joints. It is a chronic inflammatory disease associated with increased mortality mainly due to cardiovascular involvement. Radiography is the initial imaging choice to assess disease progression over time and detect bone erosions. Prognosis is poorer with factors like high antibody titers, extra-articular manifestations, and younger age of onset.
This document provides information on seronegative spondyloarthropathies, including ankylosing spondylitis, reactive arthritis, epidemiology, immunopathology, clinical features, investigations, and treatment. Ankylosing spondylitis primarily affects the axial skeleton and is associated with HLA-B27 positivity in 90% of cases. Reactive arthritis develops following enteric or urogenital infections and can range from isolated joint involvement to multi-system disease. Both conditions are treated initially with NSAIDs, while more severe cases may require TNF-alpha inhibitors or other immunosuppressants.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
3. PATHOPHYSIOLOGY
Panarteritis with inflammatory mononuclear cells
and occasionally giant cells
Marked intimal proliferation and fibrosis
Scarring, disruption and degeneration of the elastic
lamina
Narrowing of lumen – thrombosis +/-
Vasa vasorum – frequently involved
7. DIAGNOSIS
Mainly clinical
Strongly suspect in – young woman with decreased/absent
peripheral pulses, discreptancies in BP + arterial bruits
Confirmed by arteriography irregular vessel walls,
stenosis , post stenotic dilation, aneurysm, increased
collateral circulation
Histiopath – vessel wall inflammation – predominantly
lymphocytic with granuloma formation + giant cells
involving media and adventitia
8. TREATMENT AND PROGNOSIS
5 yr mortality rate – 0 to 35%
Mortalitiy often due to CCF, cerebrovascular events, MI, aneurysm
rupture, renal failure
Glucocorticoid therapy – 40-60mg/d prednisolone reduces symptoms
Refractory cases – methotrexate upto 25mg / week
9. Introduction, Aims & Objectives Methods & Results Conclusions
A Rare case of Takayasu’s Arteritis presenting with Congestive
Cardiac Failure
)Institute Name (AJ Institute Of Medical Sciences)
Authors (Dr.Rohit Rajeevan Chodaparambil K, Dr.Shafeel Ibrahim K)
Case Report- A Rare case of Takayasus
Arteritis presenting with Congestive
Cardiac Failure
Author’s Name- Dr.Rohit Rajeevan
Chodaparambil K,
Dr.Shafeel Ibrahim
Presenting Author- Dr.Rohit Rajeevan
Chodaparambil K
Institution name- A J INSTITUTE OF MEDICAL
SCIENCES, MANGALORE.
INTRODUCTION-
Takayasu’s arteritis is an inflammatory disase
often affecting the ascending aorta and
aortic arch, causing obstruction of the
aorta and its major arteries.
The pathology is a panarteritis characterized
by mononuclear cells and occasionally
giant cells, with marked intimal
hyperplasia, medial and adventitial
thickening and in the chronic form,
fibrotic occlusion.
Cardiac involvement in Takayasu’s arteritis is
rare and seen in ~ 10% individuals.
CASE- A 45 year old female with no pre-existing co-morbidities
presented with exertional dyspnea and bilateral pitting oedema
since a month.
On examination, radial and brachial pulses in bilateral upper limbs
were not palpable and blood pressure was recorded as
130/110mmHg. Apex beat was displaced laterally and
downwards and was well sustained. Jugular venous pressure
was elevated. Blood pressure in bilateral lower limbs was
200/100mmHg.
2D echo showed moderate pulmonary hypertension with PASP =
60mmHg and multiple regional wall motion abnormalities. Her
blood parameters and abdominal ultrasound were within normal
limits. VDRL was negative
CT aortogram was performed which showed pancardiomegaly,
narrowing in the abdominal aorta and multiple intraluminal
calcifications.
As per ACR criteria, she was diagnosed to have Takayasu’s arteritis
and given supportive treatment with diuretics, ACE inhibitors,
low dose corticosteroids following which her condition improved.
She was discharged and advised to continue her medications and
regular follow up.
The prevalence of cardiac involvement
in Takayasu’s arteritis in the form of
congestive cardiac failure is rare
<10%. Steroids may be used in
conservative management. Surgical
management may be indicated in
cases with recurrent stenosis.
10. IGA VASCULITIS ( HENOCH SCHONLEIN)
Small vessel vasculitis
Palpable purpura ( over buttocks , lower
extremities )
Arthralgias
GI signs and symptoms
Glomerulonephritis
11. INCIDENCE AND PREVALENCE
Usually in children
Age 4 – 7 years
Male to female = 1.5 : 1
Seasonal variation , peak incidence in spring
17. TREATMENT AND PROGNOSIS
Excellent prognosis
Prednisolone – 1 mg/kg/day , taper according to
response
Patients with RPGN – intensive plasma exchange +
cytotoxic drugs
Recurrence – 10-40% pts
18. CRYOGLOBULINEMIC VASCULITIS
Cryoglobulins – cold-precipitable monoclonal or polyclonal
immunoglobulins
Maybe associated with systemic vasculitis
Characterized by palpable purpura, arthralgia, weakness,
neuropathy, glomerulonephritis
Associated with multiple myeloma, lymphoproliferative
disorders, connective tissue disease, maybe idiopathic
Can be seen with hep C infection
19. PATHOPHYSIOLOGY
Inflammatory infiltrate surrounding and involving blood
vessel walls
Fibrinoid necrosis, endothelial cell hyperplasia,
haemorrhage
Immunoglobulin and complement deposition – common
MPGN – 80% of all renal lesions
21. LABS
Circulating cryopreciptitates +
RA factor +ve
Hypocomplementemia in 90% patients
ESR elevated
Anemia
Check for hep C infn hep C RNA , antibodies to
hep C
22. TREATMENT AND PROGNOSIS
Acute mortality uncommon.
Presence of glomerulonephritis – poor prognostic sign ;
15% progress to ESRD, 40% later develop fatal CV disease,
infn or liver failure
If hep C +ve – antiviral therapy maybe improve outcome
Rituximab – can be used in combination with anti viral
therapy
23. KAWASAKI DISEASE
Acute, febrile multisystem disease of children
80% cases < 5yr age
Peak incidence < 2yr
Non suppurative cervical adenitis and changes in skin ,
mucus membranes
Erythema of oral cavity, lips , palms
Desquamation of skin of fingertips
Benign and self limiting condition
24. Coronary A aneurysm ~ 25% cases
Usually it occurs in 3rd – 4th week of illness in convalescent
phase
Pathophysio - > intimal proliferation and infiltration of the
vessel wall with mononuclear cells
Beadlike aneurysms + thromboses along the artery
Other manifestations – pericarditis, myocarditis, MI ,
cardiomegaly
25. Excellent prognosis
High dose IV γ-globulin ( 2g/kg single infusion
over 10h ) + aspirin (100mg/kg/day x 14 days )
followed by 3-5 mg/kg/d for several weeks
effective in reducing prevalence of coronary A
abnormalities.
Surgery in pts with giant coronary A aneurysms or
other complications thromboendarterectomy ,
thrombus clearing , aneurysmal reconstruction,
bypass sx.