Abstract
The vasculitides are a rare group of heterogeneous diseases where the defining feature is inflammation of vessel walls, leading to end-organ damage. These conditions have been usually classified based on the caliber of the blood vessel involved. In recent years, our understanding of these conditions has increased, leading to the development of new therapies and better outcomes in their treatment. In this chapter, we summarize the clinical presentation as well as the diagnostic approach and treatment to the most common forms of primary systemic vasculitis.
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Abbreviations
- AAV:
-
ANCA-associated vasculitis
- ADA2:
-
Adenosine deaminase 2
- AION:
-
Acute ischemic optic neuropathy
- ANCA:
-
Antineutrophil cytoplasmic antibody
- BS:
-
Behcet’s syndrome
- c-ANCA:
-
cytoplasmic ANCA
- CNS:
-
Central nervous system
- CRP:
-
C-reactive protein
- CTA:
-
Computed tomography angiography
- CTD:
-
Connective tissue diseases
- CV:
-
Cryoglobulinemic vasculitis
- DAH:
-
Diffuse alveolar hemorrhage
- ECG:
-
Electrocardiogram
- EGPA:
-
Eosinophilic granulomatosis with polyangiitis
- ESR:
-
Erythrocyte sedimentation rate
- FDG-PET:
-
18-fluorodeoxyglucose-positron tomography
- GBM:
-
Anti-glomerular basement membrane
- GCA:
-
Giant cell arteritis
- GCs:
-
Glucocorticoids
- GI:
-
Gastrointestinal
- GPA:
-
Granulomatosis with polyangiitis
- HBV:
-
Hepatitis B virus
- HCV:
-
Hepatitis C virus
- HLA:
-
Human leukocyte antigen
- ICI:
-
Immune-checkpoint inhibitors
- IRAE:
-
Immune-related adverse event
- LVV:
-
Large-vessel vasculitis
- MPA:
-
Microscopic polyangiitis
- MPO:
-
Myeloperoxidase
- MRA:
-
Magnetic resonance angiography
- MRI:
-
Magnetic resonance imaging
- PAN:
-
Polyarteritis nodosa
- p-ANCA:
-
peripheral ANCA
- PFAPA:
-
Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenopathy
- PMR:
-
Polymyalgia rheumatica
- PR3:
-
Proteinase 3
- RPGN:
-
Rapidly progressive glomerulonephritis
- SGS:
-
Subglottic stenosis
- TA:
-
Temporal artery
- TAK:
-
Takayasu’s arteritis
References
Jennette JC. Overview of the 2012 revised International Chapel Hill Consensus Conference nomenclature of vasculitides. Clin Exp Nephrol. 2013;17(5):603–6. https://doi.org/10.1007/s10157-013-0869-6.
Mohammad AJ, et al. Incidence and mortality rates of biopsy-proven giant cell arteritis in southern Sweden. Ann Rheum Dis. 2015;74(6):993–7. https://doi.org/10.1136/annrheumdis-2013-204652.
Crowson CS, et al. The lifetime risk of adult-onset rheumatoid arthritis and other inflammatory autoimmune rheumatic diseases. Arthritis Rheum. 2011;63(3):633–9. https://doi.org/10.1002/art.30155.
Kermani TA, et al. Utility of erythrocyte sedimentation rate and C-reactive protein for the diagnosis of giant cell arteritis. Semin Arthritis Rheum. 2012;41(6):866–71. https://doi.org/10.1016/j.semarthrit.2011.10.005.
Rubenstein E, et al. Sensitivity of temporal artery biopsy in the diagnosis of giant cell arteritis: a systematic literature review and meta-analysis. Rheumatology (Oxford). 2020;59(5):1011–20. https://doi.org/10.1093/rheumatology/kez385.
Stone JH, et al. Trial of tocilizumab in Giant-cell arteritis. N Engl J Med. 2017;377(4):317–28. https://doi.org/10.1056/NEJMoa1613849.
Zhou Q, et al. Early-onset stroke and vasculopathy associated with mutations in ADA2. N Engl J Med. 2014;370(10):911–20. https://doi.org/10.1056/NEJMoa1307361.
Guillevin L, et al. Prognostic factors in polyarteritis nodosa and Churg-Strauss syndrome. A prospective study in 342 patients. Medicine. 1996;75(1):17–28. https://doi.org/10.1097/00005792-199601000-00003.
McDermott G, et al. Association of cigarette smoking with antineutrophil cytoplasmic antibody-associated vasculitis. JAMA Intern Med. 2020;180(6):1–7. https://doi.org/10.1001/jamainternmed.2020.0675.
Quinn KA, et al. Subglottic stenosis and endobronchial disease in granulomatosis with polyangiitis. Rheumatology (Oxford). 2019;58(12):2203–11. https://doi.org/10.1093/rheumatology/kez217.
Stone JH, et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N Engl J Med. 2010;363(3):221–32. https://doi.org/10.1056/NEJMoa0909905.
Walsh M, et al. Plasma exchange and glucocorticoids in severe ANCA-associated Vasculitis. N Engl J Med. 2020;382(7):622–31. https://doi.org/10.1056/NEJMoa1803537.
Guillevin L, et al. Rituximab versus azathioprine for maintenance in ANCA-associated vasculitis. N Engl J Med. 2014;371(19):1771–80. https://doi.org/10.1056/NEJMoa1404231.
Wechsler ME, et al. Mepolizumab or placebo for eosinophilic granulomatosis with Polyangiitis. N Engl J Med. 2017;376(20):1921–32. https://doi.org/10.1056/NEJMoa1702079.
Hatemi G, et al. Trial of Apremilast for Oral ulcers in Behçet's syndrome. N Engl J Med. 2019;381(20):1918–28. https://doi.org/10.1056/NEJMoa1816594.
Daxini A, et al. Vasculitis associated with immune checkpoint inhibitors-a systematic review. Clin Rheumatol. 2018;37(9):2579–84. https://doi.org/10.1007/s10067-018-4177-0.
Steinberg AW, et al. Trends in Antineutrophil cytoplasmic autoantibody-associated Vasculitis-related mortality in the United States, 1999 to 2017. Ann Intern Med. 2020;172(2):160–3. https://doi.org/10.7326/m19-1564.
Wallace ZS, et al. All-cause and cause-specific mortality in ANCA-associated vasculitis: overall and according to ANCA type. Rheumatology (Oxford). 2019; https://doi.org/10.1093/rheumatology/kez589.
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Sattui, S.E., Spiera, R.F. (2022). Vasculitis. In: Ali, Y. (eds) Rheumatology for Primary Care Providers. Springer, Cham. https://doi.org/10.1007/978-3-030-80699-6_14
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DOI: https://doi.org/10.1007/978-3-030-80699-6_14
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