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Small-vessel vasculitis

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Abstract

Small-vessel vasculitis is a convenient descriptor for a wide range of diseases characterized by vascular inflammation of the venules, capillaries, and/or arterioles with plemorphic clinical manifestations. The classical clinical phenotype is leukocytoclastic vasculitis with palpable purpura, but manifestations vary widely depending upon the organs involved. Histopathologic examination in leukocytoclastic vasculitis reveals angiocentric segmental inflammation, fibrinoid necrosis, and a neutrophilic infiltrate around the blood vessel walls with erythrocyte extravasation. The etiology of small-vessel vasculitis is unknown in many cases, but in others, drugs, post viral syndromes, malignancy, primary vasculitis such as microscopic polyarteritis, and connective tissue disorders are associated. The diagnosis of small-vessel vasculitis relies on a thorough history and physical examination, as well as relevant antibody testing including antinuclear antibody and antineutrophil cytoplasmic antibody, hepatitis B and C serologies, assessment of complement, immunoglobulins, blood count, serum creatinine, liver function tests, urinalysis, radiographic imaging, and biopsy.

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Authors and Affiliations

  1. Division of Rheumatology, Mayo Clinic College of Medicine, 200 First Street, Southwest, Rochester, MN, 55905, USA

    Eric L. Matteson MD, MPH

Authors
  1. Antonio Iglesias-Gamarra MD
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  2. José Félix Restrepo MD
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  3. Eric L. Matteson MD, MPH
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Correspondence to Eric L. Matteson MD, MPH.

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Iglesias-Gamarra, A., Restrepo, J.F. & Matteson, E.L. Small-vessel vasculitis. Curr Rheumatol Rep 9, 304–311 (2007). https://doi.org/10.1007/s11926-007-0049-3

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  • DOI: https://doi.org/10.1007/s11926-007-0049-3

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