This document provides an overview of vasculitis, including definitions, classifications, pathogenesis, and descriptions of specific types of vasculitis such as giant cell arteritis, Takayasu arteritis, polyarteritis nodosa, Kawasaki disease, granulomatosis with polyangiitis, microscopic polyangiitis, Churg-Strauss syndrome, Henoch-Schönlein purpura, and cryoglobulinemic vasculitis. Key aspects covered include the vessel sizes involved, clinical presentations, histopathological findings, differentials, and associations with certain autoantibodies.
Vasculitis is inflammation of blood vessels that can involve different vessel sizes and patterns. It is characterized by leukocytic infiltration of vessel walls. The main causes are immune complex formation, ANCA mediated, and T lymphocyte mediated processes. Diagnosis involves evaluating clinical features, lab tests like ANCA and complement levels, and biopsy of affected tissues. Treatment focuses on immunosuppression with glucocorticoids and other agents depending on severity and organ involvement. Vasculitis often follows a chronic relapsing course.
Vasculitis
pathology
Define and classify vasculitis.
Describe the cause, pathogenesis, morphology, and clinical presentation of various types of vasculitis.
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
Vasculitis refers to inflammation of blood vessels. This document discusses the pathophysiology, classification, clinical presentation, diagnosis, and treatment of various types of vasculitis. The main types include large vessel vasculitis (e.g. giant cell arteritis, Takayasu arteritis), medium vessel vasculitis (e.g. polyarteritis nodosa, Kawasaki disease), small vessel vasculitis (ANCA-associated vasculitis like granulomatosis with polyangiitis, microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis), and immune complex small vessel vasculitis (e.g. IgA vasculitis, antiglomer
This document provides an overview of different types of vasculitis. It discusses the pathogenesis of vasculitis including immune complex formation and ANCA-mediated mechanisms. It then describes the clinical presentations and characteristics of various vasculitides that involve different vessel sizes such as giant cell arteritis, Takayasu's arteritis, polyarteritis nodosa, Kawasaki disease, ANCA-associated vasculitis (granulomatosis with polyangiitis, microscopic polyangiitis, Churg-Strauss syndrome), cutaneous small vessel vasculitis, and IgA vasculitis. It provides details on the patterns of organ involvement, diagnostic criteria and clinical course for each type of vasculitis.
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.
The document provides information on different types of vasculitis:
[1] Any blood vessel can be affected by vasculitis, causing inflammation that leads to occlusion, aneurysm, ischemia and hemorrhage. The small vessel vasculitides include ANCA-associated disorders like Wegener's granulomatosis and types mediated by immune complexes.
[2] The approach to a patient with vasculitis involves considering signs and symptoms, performing tests and biopsies of affected organs to determine which organ systems are involved and the extent of involvement. Treatment depends on the specific type of vasculitis.
[3] Examples of specific vasculitides discussed include giant cell arteritis, poly
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.
Vasculitis is inflammation of blood vessels that can involve different vessel sizes and patterns. It is characterized by leukocytic infiltration of vessel walls. The main causes are immune complex formation, ANCA mediated, and T lymphocyte mediated processes. Diagnosis involves evaluating clinical features, lab tests like ANCA and complement levels, and biopsy of affected tissues. Treatment focuses on immunosuppression with glucocorticoids and other agents depending on severity and organ involvement. Vasculitis often follows a chronic relapsing course.
Vasculitis
pathology
Define and classify vasculitis.
Describe the cause, pathogenesis, morphology, and clinical presentation of various types of vasculitis.
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
Vasculitis refers to inflammation of blood vessels. This document discusses the pathophysiology, classification, clinical presentation, diagnosis, and treatment of various types of vasculitis. The main types include large vessel vasculitis (e.g. giant cell arteritis, Takayasu arteritis), medium vessel vasculitis (e.g. polyarteritis nodosa, Kawasaki disease), small vessel vasculitis (ANCA-associated vasculitis like granulomatosis with polyangiitis, microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis), and immune complex small vessel vasculitis (e.g. IgA vasculitis, antiglomer
This document provides an overview of different types of vasculitis. It discusses the pathogenesis of vasculitis including immune complex formation and ANCA-mediated mechanisms. It then describes the clinical presentations and characteristics of various vasculitides that involve different vessel sizes such as giant cell arteritis, Takayasu's arteritis, polyarteritis nodosa, Kawasaki disease, ANCA-associated vasculitis (granulomatosis with polyangiitis, microscopic polyangiitis, Churg-Strauss syndrome), cutaneous small vessel vasculitis, and IgA vasculitis. It provides details on the patterns of organ involvement, diagnostic criteria and clinical course for each type of vasculitis.
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.
The document provides information on different types of vasculitis:
[1] Any blood vessel can be affected by vasculitis, causing inflammation that leads to occlusion, aneurysm, ischemia and hemorrhage. The small vessel vasculitides include ANCA-associated disorders like Wegener's granulomatosis and types mediated by immune complexes.
[2] The approach to a patient with vasculitis involves considering signs and symptoms, performing tests and biopsies of affected organs to determine which organ systems are involved and the extent of involvement. Treatment depends on the specific type of vasculitis.
[3] Examples of specific vasculitides discussed include giant cell arteritis, poly
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 systemic vasculitis for medical residents. It defines vasculitis as inflammation of blood vessels and explains how different types of vasculitis can affect different vessel sizes and organ systems. The document outlines the clinical approach to diagnosing vasculitis through history, physical exam, lab tests, imaging studies and tissue biopsies. It then discusses several specific types of vasculitis in more detail, including giant cell arteritis, granulomatous polyangiitis (Wegener's), and microscopic polyangiitis. The presentation provides information on clinical manifestations, diagnostic criteria, pathology findings, and treatments for these forms of 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 discusses several types of vasculitis:
1. Giant cell arteritis affects large arteries in the head and is characterized by granulomatous inflammation and headache along the temporal artery.
2. Polyarteritis nodosa involves medium and small arteries throughout the body and causes tissue ischemia. It is associated with hepatitis B/C.
3. Wegener's granulomatosis is defined by necrotizing granulomas of the respiratory tract, necrotizing vasculitis of small vessels, and renal disease. It is linked to C-ANCA antibodies.
4. Leukocytoclastic vasculitis mainly involves small skin blood vessels and is characterized by skin purpura
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.
1. The document outlines a 6 step approach to diagnosing and treating vasculitis.
2. Step 1 is to learn to recognize vasculitis based on common features like purpura, pulmonary infiltrates, glomerulonephritis.
3. Step 2 is to rule out secondary causes of vasculitis like infections, malignancies, drugs.
4. Step 3 involves determining the pattern of vessel involvement - large, medium, or small vessels.
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.
Inflammatory disorders of the blood vessels, known as vasculitides, can affect arteries, veins, and capillaries through various immunological mechanisms. Three key types are summarized: (1) Large vessel vasculitis like giant cell arteritis typically involves the temporal artery and causes headaches and vision problems. (2) Medium vessel vasculitis such as polyarteritis nodosa involves arteries in organs like the kidneys and skin. (3) Small vessel vasculitis often presents as palpable purpura on the skin such as in Henoch-Schönlein purpura, a type of vasculitis more common in children.
D. Fadhil Vasculitis-7 (Muhadharaty) (1).pptxhussainAltaher
Vasculitides are a group of rare diseases characterized by inflammation and necrosis of blood vessels. They are classified based on the size of affected vessels into large, medium, and small vessel vasculitis. Some of the main types discussed in the document include giant cell arteritis/polymyalgia rheumatica, Takayasu's arteritis, polyarteritis nodosa, Churg-Strauss syndrome, Wegener's granulomatosis, and Henoch Schonlein purpura. The document provides details on clinical features, investigations, treatments, and prognosis for each type of vasculitis.
The document outlines a 6 step approach to diagnosing and treating vasculitis:
1. Recognize features of vasculitis like purpura or organ ischemia.
2. Rule out secondary causes through tests for infections and malignancies.
3. Determine the size of blood vessels involved - large, medium, or small.
4. Consider characteristic presentations of primary vasculitides like temporal arteritis or Wegener's.
5. Make diagnoses through tests like ANCA, biopsy of affected tissues, and angiography.
6. Treat based on severity, using immunosuppression, addressing underlying causes, and monitoring for side effects.
Vasculitis refers to the inflammatory destruction of blood vessels. It affects people of all ages and can be chronic and relapsing in nature. Vasculitis is classified based on the size of the blood vessels involved, such as large, medium, or small vessels. Diagnosis involves ruling out other conditions through biopsies and tests. Treatment focuses on inducing remission through immunosuppressants, while monitoring for disease activity and damage over the long term. Patients experience a significant burden from both the disease and treatment side effects like pain and fatigue.
Vasculitis refers to inflammation of blood vessels. It affects people of all ages and can be chronic and relapsing in nature. Vasculitis is classified based on the size of blood vessels involved, such as large, medium, or small vessels. Diagnosis involves ruling out other conditions through biopsies and tests. Treatment aims to induce remission through immunosuppressants, while monitoring focuses on preventing damage to organs. Even in remission, patients commonly experience pain, fatigue, and long-term consequences from both the disease and its treatments.
Vasculitis refers to a group of disorders characterized by inflammation of blood vessels. The two main pathogenic mechanisms are immune-mediated inflammation and direct infection of blood vessels. Vasculitides are classified by the size of vessels affected, such as large-vessel vasculitis including giant cell arteritis, or small-vessel vasculitis including Wegener's granulomatosis. Diagnosis involves clinical features along with tests like ANCA. Treatment depends on the specific condition but often involves steroids and other immunosuppressants.
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
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.
This document discusses different types of vasculitis syndromes. It defines vasculitis as destructive inflammation within blood vessel walls. Vasculitis is classified based on the size of vessels involved, such as large, medium, or small vessels. Clinical features vary depending on the type and size of vessels affected. Diagnosis involves investigations like biopsy and angiography. Management typically involves immunosuppressive drugs like steroids. Complications can include organ damage if untreated.
1. The document discusses various types of primary vasculitis classified by vessel size, including giant cell arteritis, Takayasu's arteritis, polyarteritis nodosa, Kawasaki disease, eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome), granulomatosis with polyangiitis (Wegener's granulomatosis), and Henoch-Schönlein purpura.
2. It provides details on clinical presentations, investigations, treatments, and pathogenic mechanisms of these conditions.
3. Granulomatosis with polyangiitis is characterized by necrotizing granulomatous vasculitis of the upper and lower airways
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that causes inflammation of small and medium arteries. It predominantly affects the arteries of the kidneys, heart, liver, and gastrointestinal tract, causing ischemia and tissue damage. The pathology is characterized by segmental necrotizing inflammation of the arterial walls. PAN is diagnosed based on biopsy of an affected organ showing arteritis or angiography demonstrating aneurysms of small and medium arteries. Treatment involves high-dose glucocorticoids and cyclophosphamide to induce remission, though relapse can occur in 10-20% of cases.
This presentation is about pulmonary manifestations of systemic vasculitis,in it m discussing about WEGNER,S GRANULOMATOSIS, churg-strauss syndrome and MPA
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.
This document provides an overview of systemic vasculitis for medical residents. It defines vasculitis as inflammation of blood vessels and explains how different types of vasculitis can affect different vessel sizes and organ systems. The document outlines the clinical approach to diagnosing vasculitis through history, physical exam, lab tests, imaging studies and tissue biopsies. It then discusses several specific types of vasculitis in more detail, including giant cell arteritis, granulomatous polyangiitis (Wegener's), and microscopic polyangiitis. The presentation provides information on clinical manifestations, diagnostic criteria, pathology findings, and treatments for these forms of 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 discusses several types of vasculitis:
1. Giant cell arteritis affects large arteries in the head and is characterized by granulomatous inflammation and headache along the temporal artery.
2. Polyarteritis nodosa involves medium and small arteries throughout the body and causes tissue ischemia. It is associated with hepatitis B/C.
3. Wegener's granulomatosis is defined by necrotizing granulomas of the respiratory tract, necrotizing vasculitis of small vessels, and renal disease. It is linked to C-ANCA antibodies.
4. Leukocytoclastic vasculitis mainly involves small skin blood vessels and is characterized by skin purpura
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.
1. The document outlines a 6 step approach to diagnosing and treating vasculitis.
2. Step 1 is to learn to recognize vasculitis based on common features like purpura, pulmonary infiltrates, glomerulonephritis.
3. Step 2 is to rule out secondary causes of vasculitis like infections, malignancies, drugs.
4. Step 3 involves determining the pattern of vessel involvement - large, medium, or small vessels.
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.
Inflammatory disorders of the blood vessels, known as vasculitides, can affect arteries, veins, and capillaries through various immunological mechanisms. Three key types are summarized: (1) Large vessel vasculitis like giant cell arteritis typically involves the temporal artery and causes headaches and vision problems. (2) Medium vessel vasculitis such as polyarteritis nodosa involves arteries in organs like the kidneys and skin. (3) Small vessel vasculitis often presents as palpable purpura on the skin such as in Henoch-Schönlein purpura, a type of vasculitis more common in children.
D. Fadhil Vasculitis-7 (Muhadharaty) (1).pptxhussainAltaher
Vasculitides are a group of rare diseases characterized by inflammation and necrosis of blood vessels. They are classified based on the size of affected vessels into large, medium, and small vessel vasculitis. Some of the main types discussed in the document include giant cell arteritis/polymyalgia rheumatica, Takayasu's arteritis, polyarteritis nodosa, Churg-Strauss syndrome, Wegener's granulomatosis, and Henoch Schonlein purpura. The document provides details on clinical features, investigations, treatments, and prognosis for each type of vasculitis.
The document outlines a 6 step approach to diagnosing and treating vasculitis:
1. Recognize features of vasculitis like purpura or organ ischemia.
2. Rule out secondary causes through tests for infections and malignancies.
3. Determine the size of blood vessels involved - large, medium, or small.
4. Consider characteristic presentations of primary vasculitides like temporal arteritis or Wegener's.
5. Make diagnoses through tests like ANCA, biopsy of affected tissues, and angiography.
6. Treat based on severity, using immunosuppression, addressing underlying causes, and monitoring for side effects.
Vasculitis refers to the inflammatory destruction of blood vessels. It affects people of all ages and can be chronic and relapsing in nature. Vasculitis is classified based on the size of the blood vessels involved, such as large, medium, or small vessels. Diagnosis involves ruling out other conditions through biopsies and tests. Treatment focuses on inducing remission through immunosuppressants, while monitoring for disease activity and damage over the long term. Patients experience a significant burden from both the disease and treatment side effects like pain and fatigue.
Vasculitis refers to inflammation of blood vessels. It affects people of all ages and can be chronic and relapsing in nature. Vasculitis is classified based on the size of blood vessels involved, such as large, medium, or small vessels. Diagnosis involves ruling out other conditions through biopsies and tests. Treatment aims to induce remission through immunosuppressants, while monitoring focuses on preventing damage to organs. Even in remission, patients commonly experience pain, fatigue, and long-term consequences from both the disease and its treatments.
Vasculitis refers to a group of disorders characterized by inflammation of blood vessels. The two main pathogenic mechanisms are immune-mediated inflammation and direct infection of blood vessels. Vasculitides are classified by the size of vessels affected, such as large-vessel vasculitis including giant cell arteritis, or small-vessel vasculitis including Wegener's granulomatosis. Diagnosis involves clinical features along with tests like ANCA. Treatment depends on the specific condition but often involves steroids and other immunosuppressants.
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
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.
This document discusses different types of vasculitis syndromes. It defines vasculitis as destructive inflammation within blood vessel walls. Vasculitis is classified based on the size of vessels involved, such as large, medium, or small vessels. Clinical features vary depending on the type and size of vessels affected. Diagnosis involves investigations like biopsy and angiography. Management typically involves immunosuppressive drugs like steroids. Complications can include organ damage if untreated.
1. The document discusses various types of primary vasculitis classified by vessel size, including giant cell arteritis, Takayasu's arteritis, polyarteritis nodosa, Kawasaki disease, eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome), granulomatosis with polyangiitis (Wegener's granulomatosis), and Henoch-Schönlein purpura.
2. It provides details on clinical presentations, investigations, treatments, and pathogenic mechanisms of these conditions.
3. Granulomatosis with polyangiitis is characterized by necrotizing granulomatous vasculitis of the upper and lower airways
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that causes inflammation of small and medium arteries. It predominantly affects the arteries of the kidneys, heart, liver, and gastrointestinal tract, causing ischemia and tissue damage. The pathology is characterized by segmental necrotizing inflammation of the arterial walls. PAN is diagnosed based on biopsy of an affected organ showing arteritis or angiography demonstrating aneurysms of small and medium arteries. Treatment involves high-dose glucocorticoids and cyclophosphamide to induce remission, though relapse can occur in 10-20% of cases.
This presentation is about pulmonary manifestations of systemic vasculitis,in it m discussing about WEGNER,S GRANULOMATOSIS, churg-strauss syndrome and MPA
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.
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Health Tech Market Intelligence Prelim Questions -Gokul Rangarajan
The Ultimate Guide to Setting up Market Research in Health Tech part -1
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
This lays foundation of scoping research project what are the
Before embarking on a research project, especially one aimed at scoping and defining parameters like the one described for health tech IT, several crucial considerations should be addressed. Here’s a comprehensive guide covering key aspects to ensure a well-structured and successful research initiative:
1. Define Research Objectives and Scope
Clear Objectives: Define specific goals such as understanding market needs, identifying new opportunities, assessing risks, or refining pricing strategies.
Scope Definition: Clearly outline the boundaries of the research in terms of geographical focus, target demographics (e.g., age, socio-economic status), and industry sectors (e.g., healthcare IT).
3. Review Existing Literature and Resources
Literature Review: Conduct a thorough review of existing research, market reports, and relevant literature to build foundational knowledge.
Gap Analysis: Identify gaps in existing knowledge or areas where further exploration is needed.
4. Select Research Methodology and Tools
Methodological Approach: Choose appropriate research methods such as surveys, interviews, focus groups, or data analytics.
Tools and Resources: Select tools like Google Forms for surveys, analytics platforms (e.g., SimilarWeb, Statista), and expert consultations.
5. Ethical Considerations and Compliance
Ethical Approval: Ensure compliance with ethical guidelines for research involving human subjects.
Data Privacy: Implement measures to protect participant confidentiality and adhere to data protection regulations (e.g., GDPR, HIPAA).
6. Budget and Resource Allocation
Resource Planning: Allocate resources including time, budget, and personnel required for each phase of the research.
Contingency Planning: Anticipate and plan for unforeseen challenges or adjustments to the research plan.
7. Develop Research Instruments
Survey Design: Create well-structured surveys using tools like Google Forms to gather quantitative data.
Interview and Focus Group Guides: Prepare detailed scripts and discussion points for qualitative data collection.
8. Sampling Strategy
Sampling Design: Define the sampling frame, size, and method (e.g., random sampling, stratified sampling) to ensure representation of target demographics.
Participant Recruitment: Plan recruitment strategies to reach and engage the intended participant groups effectively.
9. Data Collection and Analysis Plan
Data Collection: Implement methods for data gathering, ensuring consistency and validity.
Analysis Techniques: Decide on analytical approaches (e.g., statistical
India Home Healthcare Market: Driving Forces and Disruptive Trends [2029]Kumar Satyam
According to the TechSci Research report titled "India Home Healthcare Market - By Region, Competition, Forecast and Opportunities, 2029," the India home healthcare market is anticipated to grow at an impressive rate during the forecast period. This growth can be attributed to several factors, including the rising demand for managing health issues such as chronic diseases, post-operative care, elderly care, palliative care, and mental health. The growing preference for personalized healthcare among people is also a significant driver. Additionally, rapid advancements in science and technology, increasing healthcare costs, changes in food laws affecting label and product claims, a burgeoning aging population, and a rising interest in attaining wellness through diet are expected to escalate the growth of the India home healthcare market in the coming years.
Browse over XX market data Figures spread through 70 Pages and an in-depth TOC on "India Home Healthcare Market”
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The Importance of Black Women Understanding the Chemicals in Their Personal C...bkling
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2. • DEFINITION: Vasculitis is a clinicopathological
process characterized by inflammation of and damage
to blood vessels. The vessel lumen is usually
compromised, and this is associated with ischemia of
the tissues supplied by the involved vessel.
3. PATHOPHYSIOLOGYAND PATHOGENESIS
• Immune complex formation
• ANCA mediated
• T lymphocyte mediated granuloma formation
• Immunopathogenic mechanisms that occur in response to certain antigenic
stimuli.
4.
5.
6. CHAPEL HILL CLASSIFICATION
Large vessels Aorta and its major branches and the
analogous veins.
1-GIANT CELL ARTERITIS/ TEMPORAL
ARTERITIS,
2-TAKAYASU ARTERITIS.
Medium vessels : The main visceral arteries , veins and
their initial branches.
1-POLYARTERITIS NODOSA
2- KAWASAKI DISEASE
Small vessels Intraparenchymal arteries, arterioles,
capillaries, venules, and veins.
ANCA POSITIVE -1-MICROSCOPIC
POLYANGIITIS
2-WEGENERS GRANULOMATOSIS (GPA)
3-CHURG STRAUSS SYNDROME (EGPA)
ANCA NEGATIVE -1-HENOCH
SCHONLEIN PURPURA
2-CRYOGLOBULINAMIC VASCULITIS
7. Classification of Vasculitis according to the 2012 Revised International Chapel Hill Consensus
Conference on the Nomenclature of Systemic Vasculitides
(Primary angitis of central nervous system)
8. TYPES OF VASCULITIS CATEGORISED ON THE BASIS OF PROPOSED PATHOGENIC
MECHANISM
• DIRECT INFECTION OF VESSEL
• Bacterial vasculitis
• Mycobacterial vasculitis
• Syphilitic vasculitis
• Rickettsial vasculitis
• Fungal vasculitis
• Viral vasculitis
• IMMUNOLOGIC INJURY
• Immune complex mediated vasculitis
• Henoch-Schonlein purpura
• Cryoglobinemic vasculitis
• Lupus vasculitis
• Rheumatoid vasculitis
• Serum sickness vasculitis
• Induced by whole serum
• Induced by heterologous protein
• Infection induced immune complex vasculitis
• Viral
• Bacterial
10. LARGE VESSEL VASCULITIS
• GIANT CELLARTERITIS or TEMPORALARTERITIS:-
Age > 50
New onset headache, Jaw claudication.
Sudden onset of – blindness
Associated with polymyalgia rheumatic.
Abnormal artery biopsy (mononuclear cell infiltrate, granulomatous inflammation,
usually multinucleated giant cells)
Temporal artery abnormality (tender or decreased pulse)
Temporal artery biopsy - Since involvement of the vessel may be segmental,
positive yield is increased by obtaining a biopsy segment of 3–5 cm together
with serial sectioning of biopsy specimens
11. A- The temporal artery of a patient with classic giant cell arteritis shows a thickened, nodular
vessel on the surface of the head
B-H & E stain -temporal artery showing giant cells at the degenerated internal elastic lamina.
C-Elastic tissue stain showing focal destruction of internal elastic lamina.
13. TAKAYASU ARTERITIS= PULSELESS DISEASE= AORTIC
ARCH SYNDROME
• Onset before age of 40yrs
• Constitutional features
• Reovascular hypertension
• Decreased brachial artery pulse
• Decreased blood pressure(SBP difference >10 mmhg)
• Angiographic evidence of narrowing or occlusion of aorta or its primary branches
or large limb arteritis.
14. MICROSCOPY
A. Aortic arch angiogram showing narrowing of brachiocephalic, carotid, and subclavian arteries
B. Histologic appearance in active Takayasu aortitis- destruction and fibrosis of the arterial media associated with
mononuclear infiltrates and inflammatory giant cells
15. TAKAYASU ARTERITIS IS CATEGORISED AS-
TYPE 1- involvement of localized to aortic arch and its branches
TYPE 2- thoracic, descending, abdominal arteries
TYPE 3- combined of 1 and 2
TYPE 4- pulmonary artery
DIFFERENTIAL DIAGNOSIS
• Atherosclerosis
• Thromboangisis obliterans
• Syphilitic aortitis
• Giant cell arteritis
16.
17.
18. MEDIUM VESSEL VASCULITIS
• 1. POLYARTERITIS NODOSA-
• Necrotizing inflammation of medium or small sized artery.
• Systemic vasculitis involving renal and visceral vessels except pulmonary vessels.
• All patients should be screened for hepatitis B.
• Men > women ,age-20-60yrs
• C/F- fever, malaise, weight loss,weakness,myalgia
• Antibodies against myeloperoxidase or proteinase-3 (ANCA) are rarely found in
patients with PAN.
19. • Polyarteritis nodosa may present segmentally, and multiple stages of
inflammation (acute, chronic, and healed lesions) may be encountered
within the same patient.
• Classic Polyarteritis nodosa - segmental transmural necrotizing
inflammation
20. MICROSCOPY
Polyarteritis nodosa -Necrosis and fibrin are
present in the tunica media (arrows) of a
pancreatic artery surrounded by inflammatory
cells.
Polyarteritis nodosa- segmental fibrinoid
necrosis and thrombotic occlusion of the lumen
of this small artery.
22. • 2. KAWASAKI DISEASE-
• C – Conjunctivitis (non purulent)
• R - Rash
• A – Adenopathy ( Cervical Lymphadenopathy)
• S – Strawberry tongue
• H – Hand (Palmar erythema & swelling)
• Burn (fever lasting at least 5 days or more)
• Illness of infancy and childhood (80% of patients are 4 years old or
younger)
23. • It predominantly involve small and medium sized arteritis,
especially the coronary arteritis, so mc cause of myocardial
infraction in children.
• Area of necrosis with more leukocytes seen under
microscope.
DIFFERENTIAL DIAGNOSIS
• Polyarteritis nodosa
• Microscopic polyangiitis
25. SMALL VESSEL VASCULITIS
GRANULOMATOSIS WITH POLYANGIITIS (WEGENER'S)-
• The histopathologic hallmarks of granulomatosis with polyangiitis (Wegener's) are
necrotizing vasculitis of small arteries and veins together with granuloma
formation, which may be either intravascular or extravascular.
• Focal necrotizing, often crescentic, glomerulonephritis
• Necrotizing granulomas of the upper respiratory tract (ear, nose, sinuses, throat) or
the lower respiratory tract (lung) or both.
• Necrotizing or granulomatous vasculitis affecting small to medium-sized vessels
most prominent in the lungs and upper airways
• Associated with PR-3 ANCA, earlier known as C-ANCA.
26. Granulomas with geographic patterns of central necrosis surrounded
by zone of proliferating fibroblasts with giant cells & leukocyte
infilterates
MICROSCOPY
28. MICROSCOPIC POLYANGIITIS-
• Also called as hypersensitivity or leukocytoclastic vasculitis
• It is necrotizing vasculitis with few or no immune complexes affecting
small vessels (capillaries, venules, or arterioles). Associated with
MPO- ANCA.
• Glomerulonephritis is very common in microscopic polyangiitis, and
pulmonary capillaritis often occurs. The absence of granulomatous
inflammation in microscopic polyangiitis is said to differentiate it from
Wegener's.
• The mean age of onset is 57 years of age, and males are slightly more
frequently affected than females.
• Granulomatous inflammation is absent
31. MPA GPA PAN
BLOOD VESSEL SIZE Small to Medium Small to Medium Medium
BLOOD VESSEL TYPE Arterioles to venules, And sometimes
Arteries and veins
Arterioles to venules, And sometimes
Arteries and veins
Muscular Arteries
GRANULOMATOUS INFLAMMATION NO YES NO
LUNG SYMPTOMS YES1 YES1 NO
GLOMERULONEPHRITIS YES YES NO
RENAL HYPERTENSION NO NO YES
ANCA-POSITIVITY 75% 65-90% NO
MPA GPA PAN
32. CHURG-STRAUSS SYNDROME-
• Churg-Strauss syndrome, also referred to as eosinophilic granulomatosis with polyangitis , Also
called allergic granulomatosis and angiitis
• It is characterized by asthma, peripheral and tissue eosinophilia, extravascular granuloma
formation, and vasculitis of multiple organ systems.
• The mean age of onset is 48 years, with a female-to-male ratio of 1.2:1.
• ANCAs (mostly MPO-ANCAs) are present
• Churg- Strauss syndrome is a multisystem diseases with cutaneous involvement (palpable
purpura), gastrointestinal tract bleeding, and renal disease (primarily as focal and segmental
glomerulosclerosis).
• Myocardial involvement- cardiomyopathy
35. IgA VASCULITIS -HENOCH-SCHÖNLEIN PURPURA
• It is a small-vessel vasculitis characterized by palpable purpura (most
commonly distributed over the buttocks and lower extremities),
arthralgia, gastrointestinal signs and symptoms, and
glomerulonephritis.
• Henoch-Schönlein purpura is usually seen in children; most patients
range in age from 4 to 7years however, the disease may also be seen in
infants and adults. .
• The male-to-female ratio is 1.5:1.
38. CRYOGLOBULINAMIC VASCULITIS-
• Usually systemic disease in which deposits of IgG or IgM immune complexes
cause glomerulonephritis (focal, diffuse), cutaneous vasculitis (skin rash) and
synovitis (arthritis)
• Defined by presence of serum cryoglobulins, which are immunoglobulin complexes
that precipitate at 4°C and become soluble again at 30°C
• Type I: cryoglobulins is single monoclonal immunoglobulin class, usually due to
myeloma, Waldenström macroglobulinemia or other lymphoma
• Type II: mixture of 2+ immunoglobulins, one a monoclonal antibody against
polyclonal IgG; usually IgG-IgM, in which IgM is monoclonal and has rheumatoid
factor activity
• Type III: both immunoglobulin components are usually polyclonal IgG and IgM
39. CLINICAL FEATURES
• Cryoglobulinemia may be associated with a systemic vasculitis,
associated with HCV infection
• Meltzer’s triad (purpura, arthralgia, weakness) occurs in <40% of
patients
• neuropathy, and glomerulonephritis.
• Although this can be observed in association with a variety of
underlying disorders including multiple myeloma,lymphoproliferative
disorders, connective tissue diseases, infection, and liver disease, in
many instances it appeared to be idiopathic.
42. Thromboangiitis Obliterans:-
(Buerger`s Disease)
• Characterized by segmental, thrombosing inflammatory process
affecting intermediate and small arteries and sometimes veins
• Upper & lower extremities vessels are commonly involved
• Occurs - heavy cigarette smokers usually before age 35
• Early manifestations include cold induced Raynaud phenomenon
,intermittent claudication, instep claudication, and venous
inflammation.
• The vascular insufficiency of Burger disease tends to be accompanied
by severe pain—even at rest—undoubtedly due to the neural
involvement.
44. Bechet's Disease:-
• Neutrophilic vasculitis that classically presents as
a clinical triad of recurrent oral aphthous ulcers,
genital ulcers, and uveitis
• There is an association with certain HLA-B51 and a
cross-reactive immune response to certain
microorganisms is implicated.
• DIFFERENTIAL DIAGNOSIS:-
• Neutrophilic dermatitis
• Sweet’s syndrome
• Leulocytoclastic arteritis
46. Systemic lupus erythematosus :-
• Cutaneous vasculitis is common feature
• Mimicking the ANCA-associated vasculitis, is extremely rare but
associated with a particularly poor prognosis.
• Patients have typical autoantibodies associated with lupus including
ANA, DNA binding hypocomplementemia, and sometimes Ro and La
antibodies
• Clinical features include peripheral neuropathy, particularly
mononeuritis multiplex
• Rapidly progressive glomerulonephritis may also sometimes be
associated with systemic vasculitis
47. Systemic rheumatoid vasculitis
• Vasculitis has been known to be associated with RA for many
years.
• Recent studies have suggested that this complication is
becoming increasingly rare
• Extra articular manifestations such as nodules and pulmonary
fibrosis. The commonest findings are nail fold or nail bed
infarcts
• Vasculitis has very rarely been described as the presenting
feature of rheumatoid arthritis.
Nailfold vasculitis in a patient
with rheumatoid arthritis.
49. Histologic section of the ascending aorta
showing adventitial and medial chronic
inflammatory infiltrate.
Higher magnification from the adventitia
demonstrating obliterans and perivascular
cuffing by lymphocytes and plasma cells.
Aortic aneurysm
Syphilitic vasculitis
50. • Considerable progress has been made in understanding the pathogenesis of
vasculitis, and consequently promising biomarker discoveries.
• It should be remembered that primary outcome measures in clinical trials of
vasculitis .
• These particular monogenic forms of vasculitis have significant therapeutic
implications, and demonstrate that an understanding of the molecular basis of
vasculitis can identify new therapeutic pathways, new biomarkers and new
treatments.
UPDATES IN VASCULITIS
51. What is a biomarker, and what is it a biomarker of?
• A biomarker is defined as any characteristic that is objectively measured and
evaluated as an indicator of normal biological processes, pathogenic processes,
or pharmacological responses to a therapeutic intervention .
• biomarkers and/or new genetic tests could help include: diagnostic tests to
robustly identify important clinical phenotypes of vasculitis (for epidemiological
studies and/or clinical trials), e.g. identifying novel genetic diagnostic tests for
monogenic vasculitides and granulomatosis with polyangiitis (GPA).
• Monogenic vasculitides includes- DADA2, CANDLE and SAVI
52. ANCA-associated vasculitides-AAV
• granulomatosis with polyangiitis (GPA), most commonly associated
with proteinase 3 (PR3)-ANCA, although myeloperoxidase (MPO)-
ANCAs are present in a minority;
• microscopic polyangiitis (MPA), typically associated with MPO-
ANCA;
• single organ disease,
• renal-limited vasculitis (again mainly associated with MPO-ANCA);
and
• eosinophilic granulomatous polyangiitis (EGPA) [5]. As most
children with EGPA are in fact ANCA-negative
53. ANCA as a diagnostic biomarker
• Cases of “ANCA-negative” AAV are acknowledged, in ANCA testing methodology (including
using both indirect immunofluorescence and enzyme-linked immunosorbent assay for screening).
• It is increasingly recognized that such “ANCA-negative” AAV patients have a broad differential
diagnosis that may include entities such as chronic granulomatous disease, IgG4 disease,
monogenic granulomatous diseases including Blau syndrome, or other immune-mediated
renal pathology.
• Pediatric patients with vasculitis (particularly single organ disease)who were initially ANCA
negative, and who subsequently became ANCA positive, suggesting that the negative predictive
value of ANCA testing for patients with single organ disease at first testing might be suboptimal.
Thus, the diagnostic utility of ANCA as a biomarker for AAV is largely irrefutable , and when
positive are especially useful for those with atypical presentations and/or single organ disease.
• The fact that ANCA positivity is usually a requirement for enrolment into clinical trials involving
patients with AAV, and is included in paediatric classification criteria and adult definitions of AAV,
may amplify the notion that a decreasing number of patients are ANCA negative.
54. ANCA as a biomarker of disease activity
That an increase in the PR3-ANCA titre was not a very sensitive or specific
predictor of subsequent relapse in general, they did observe some association
between an increase in PR3-ANCA level and risk of subsequent relapse that was
dependent on specific factors.
55. Other biomarkers and miscellaneous vasculitides: endothelial injury and repair
concept
• Endothelial activation and injury are central to the pathogenesis, with increased
endothelial cell adhesion molecule expression, and a switch to a prothrombotic
endothelial phenotype, both of which contribute to the vascular pathology of
vasculitis .
Two important biomarkers of endothelial injury are –
• endothelial micro particles (EMPs),
• circulating detached mature endothelial cells (CECs).
Von Will brand factor (VWF), a plasma protein synthesized primarily by
megakaryocytes and endothelial cells, mediates platelet aggregation and adhesion .
Levels increase in response to endothelial injury or activation, and have been
described as a biomarker of disease activity in many vasculitides including KD,
HSP and AAV.