Skip to main content

Advertisement

SpringerLink
Log in

Vasculitis-like syndromes

  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Vasculitis often presents a diagnostic challenge as the disease processes may have varied presentations. This article reviews some vasculitis-like “mimics,” particularly emphasizing viral and bacterial infections, drug-related disorders, various malignancies, and other autoimmune disorders, all of which may have a similar clinical presentation. This article also highlights recent advances and the importance of accurate diagnosis and therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Stone JH: Vasculitides C. The antineutrophil cytoplasmic antibody-associated vasculitides: Wegener’s granulomatosis, microscopic polyangiitis, and the Churg-Strauss syndrome. In Primer on the Rheumatic Diseases, edn 13. Edited by Klippel JH, Stone JH, Crofford LJ, White PH. New York: Springer; 2008:416–426.

    Google Scholar 

  2. Jennette JC, Falk RJ: New insight into the pathogenesis of vasculitis associated antineutrophil cytoplasmic autoantibodies. Cur Opin Rheumatol 2008, 20:55–60.

    Article  CAS  Google Scholar 

  3. Friedman DR, Wolfsthal SD: Cocaine-induced pseudovasculitis. Mayo Clin Proc 2005, 5:671–673.

    Article  Google Scholar 

  4. Trimarchi M, Gregorini G, Facchetti F, et al.: Cocaine induced midline destructive lesions: clinical, radiographic, histopathologic and serologic features and their differentiation from Wegener’s granulomatosis. Medicine (Baltimore) 2001, 80:391–404.

    Article  CAS  Google Scholar 

  5. Weisner O, Russell KA, Lee AS, et al.: Antineutrophil cytoplasmic antibodies reacting with human neutrophil elastase as a diagnostic marker for cocaine-induced midline destructive lesions but not auto-immune vasculitis. Arthritis Rheum 2004, 50:2954–2965.

    Article  Google Scholar 

  6. Molloy ES, Langford CA: Vasculitis mimics. Cur Opin Rheumatol 2008, 20:29–34

    Article  Google Scholar 

  7. Peikert T, Finkelman JD, Hummel AM, et al.: Functional characteristics of antineutrophil cytoplasmic antibodies in patients with cocaine-induced midline destructive lesions. Arthritis Rheum 2008, 58:1546–1551.

    Article  PubMed  Google Scholar 

  8. Molloy E, Hoffman G, Langford CA: Determining the cause of isolated midline destructive lesions: comment on the clinical images presented by Kasifoglu et al. Arthritis Rheum 2009, 60:632–633.

    Article  PubMed  Google Scholar 

  9. Orriols R, Muñoz X, Ferrer J, et al.: Cocaine-induced Churg Strauss vasculitis. Eur Respir J 1996, 9:175–177.

    Article  CAS  PubMed  Google Scholar 

  10. Bhinder SK, Majithia V: Cocaine use and its rheumatic manifestations: a case report and discussion. Clin Rheumatol 2007, 26:1192–1194.

    Article  PubMed  Google Scholar 

  11. Hofbrauer GF, Hafner J, Trüeb RM: Urticarial vasculitis following cocaine use. Br J Dermatol 1999, 141:600–601.

    Article  Google Scholar 

  12. Chevalier X, Rostoker G, Larget-Piet B, Gherardi R: Schönlein-Henoch purpura with necrotizing vasculitis after cocaine snorting. Clin Nephrol 1995, 43:348–349.

    CAS  PubMed  Google Scholar 

  13. Wiik A: Drug-induced vasculitis. Cur Opin Rheumatol 2008, 20:35–39.

    Article  Google Scholar 

  14. Wiik A: Methods for the detection of anti-neutrophil cytoplasmic antibodies. Recommendations for clinical use of ANCA serology and laboratory efforts to optimize the informative value of ANCA test results. Springer Semin Immunopathol 2001, 23:217–229.

    Article  CAS  PubMed  Google Scholar 

  15. Choi HK, Merkel PA, Walker AM, Niles JL: Drug-associated antineutrophil cytoplasmic antibody-positive vasculitis: prevalence among patients with high titers of antimyeloperoxidase antibodies. Arthritis Rheum 2000, 43:405–413.

    Article  CAS  PubMed  Google Scholar 

  16. Röglin J, Böer A: Skin manifestations of intravascular lymphoma mimic inflammatory diseases of the skin. Br J Dermatol 2007, 157:16–25.

    Article  PubMed  Google Scholar 

  17. Valeriano-Marcet J, Bateman H: Rheumatology. In Visual Diagnosis, edn 3. Jupiter, FL: Merrit; 2009.

    Google Scholar 

  18. McIlwain L, Carter JD, Bin-Sagheer S, et al.: Hypersensitivity vasculitis with leukocytoclastic vasculitis secondary to infliximab. J Clin Gastroenterol 2003, 36:411–413.

    Article  CAS  PubMed  Google Scholar 

  19. Mohan N, Edwards ET, Cupps TR, et al.: Leukocytoclastic vasculitis associated with tumor necrosis factor-alpha blocking agents. J Rheum 2004, 31:1955–1958.

    CAS  PubMed  Google Scholar 

  20. Seo P: Vasculitides D. Immune complex mediated vasculitis. In Primer on the Rheumatic Diseases, edn 13. Edited by Klippel JH, Stone JH, Crofford LJ, White PH. New York: Springer; 2008:427–434.

    Google Scholar 

  21. Guillevin L: Vasculitides in the context of HIV infection. AIDS 2008, 22(Suppl 3):S27–S33.

    Article  PubMed  Google Scholar 

  22. Gherardi R, Belec L, Mhiri C, et al.: The spectrum of vasculitis in human immunodeficiency virus-infected patients. A clinicopathologic evaluation. Arthritis Rheum 1993, 36:1164–1174.

    Article  CAS  PubMed  Google Scholar 

  23. Stegeman CA, Tervaert JW, Sluiter WJ, et al.: Association of chronic nasal carriage of Staphylococcus aureus and higher relapse rates in Wegener’s granulomatosis. Ann Intern Med 1994, 120:12–17.

    CAS  PubMed  Google Scholar 

  24. Lapraik C, Watts R, Bacon P, et al.: BSR and BHPR Guidelines for the management of ANCA associated vasculitis. Rheumatology 2007, 46:1615–1616.

    Article  CAS  PubMed  Google Scholar 

  25. Choi HK, Lamprecht P, Niles JL, et al.: Subacute bacterial endocarditis with positive antineutrophil cytoplasmic antibodies and anti-proteinase 3 antibodies. Arthritis Rheum 2000, 43:226–231.

    Article  CAS  PubMed  Google Scholar 

  26. Grau R: Pseudovasculitis: mechanisms of vascular injury and clinical spectrum. Curr Rheumatol Rep 2002, 4:83–89.

    Article  PubMed  Google Scholar 

  27. Dietz HC, Cutting GR, Pyeritz RE, et al.: Marfan syndrome caused by a recurrent de novo missense mutation in the fibrillin gene. Nature 1991, 352:337–339.

    Article  CAS  PubMed  Google Scholar 

  28. Pepin M, Schwarze U, Superti-Furga A, Byers PH: Clinical and genetic features of Ehlers-Danlos syndrome type IV, the vascular type. N Engl J Med 2000, 342:673–680.

    Article  CAS  PubMed  Google Scholar 

  29. Loeys BL, Chen J, Neptune ER, et al.: A syndrome of altered cardiovascular, craniofacial neurocognitive and skeletal development caused by mutations in TGFBR1 or TGFBR2. Nat Genet 2005, 37:275–281.

    Article  CAS  PubMed  Google Scholar 

  30. Grange DK, Balfour IC, Chen SC, Wood EG: Familial syndrome of progressive arterial occlusive disease consistent with fibromuscular dysplasia, hypertension, congenital cardiac defects, bone fragility, brachysyndactyly, and learning disabilities. Am J Med Genet 1998, 75:469–480.

    Article  CAS  PubMed  Google Scholar 

  31. Libman BS, Quismorio FP Jr, Stimmler MM: Polyarteritis nodosa-like vasculitis in human immunodeficiency virus infection. J Rheumatol 1995, 22:351–355.

    CAS  PubMed  Google Scholar 

  32. Guillevin L: Virus-associated vasculitides. Rheumatology (Oxford) 1999, 38:588–590.

    Article  CAS  Google Scholar 

  33. Choi JB, Yang HW, Oh SK, Yun KJ: Rupture of ascending aorta secondary to tuberculous aortitis. Ann Thorac Surg 2003, 75:1965–1967.

    Article  PubMed  Google Scholar 

  34. Lie JT: Segmental mediolytic arteritis: not an arteritis but a variant of arterial fibromuscular dysplasia. Arch Pathol Lab Med 1992, 116:238–241.

    CAS  PubMed  Google Scholar 

  35. Lie JT: Systemic, cerebral, and pulmonary segmental mediolytic arteriopathy: villainous masqueraders of vasculitis. Cardiovasc Pathol 1996, 5:305–314.

    Article  Google Scholar 

  36. Chan RJ, Goodman TA, Aretz TH, Lie JT: Segmental mediolytic arteriopathy of the splenic and hepatic arteries mimicking systemic necrotizing vasculitis. Arthritis Rheum 1998, 41:935–938.

    Article  CAS  PubMed  Google Scholar 

  37. Caus T, Canavy I, Mesana T, et al.: Rescue revascularization for acute coronary occlusion late after radiotherapy. Ann Thorac Surg 1999, 67:236–238.

    Article  CAS  PubMed  Google Scholar 

  38. Basavaraju SR, Easterly CE: Pathophysiological effects of radiation on atherosclerosis development and progression, and the incidence of cardiovascular complications. Med Phys 2002, 29:2391–2403.

    Article  PubMed  Google Scholar 

  39. Calabrese LH, Dodick DW, Schwedt TJ, Singhal AB: Narrative review: reversible cerebral vasoconstriction syndromes. Ann Intern Med 2007, 146:34–44.

    PubMed  Google Scholar 

  40. Hajj-Ali RA, Singhal AB, Calabrese LH. Reversible cerebral vasoconstrictive syndrome [abstract] Arthritis Rheum 2008, 58(Suppl 9):S906.

    Google Scholar 

  41. Hajj-Ali RA, Furlan A, Abou-Chebel A, Calabrese LH: Benign angiopathy of the central nervous system: cohort of 16 patients with clinical course and long-term followup. Arthritis Rheum 2002, 47:662–669

    Article  PubMed  Google Scholar 

  42. Kossorotoff M, Touzé E, Godon-Hardy S, et al.: Cerebral vasculopathy with aneurysm formation in HIV-infected young adults. Neurology 2006, 66:1121–1122.

    Article  CAS  PubMed  Google Scholar 

  43. Scully M, Yarranton H, Liesner R, et al.: Regional UK TTP registry: correlation with laboratory ADAMTS 13 analysis and clinical features. Br J Haematol 2008, 142:819–826.

    Article  PubMed  Google Scholar 

  44. Calabrese LH, Duna GF, Lie JT: Vasculitis in the central nervous system. Arthritis Rheum 1997, 40:1189–1201.

    CAS  PubMed  Google Scholar 

  45. Lie JT: Malignant angioendotheliomatosis (intravascular lymphomatosis) clinically simulating primary angiitis of the central nervous system. Arthritis Rheum 1992, 35:831–834.

    Article  CAS  PubMed  Google Scholar 

  46. O’sullivan M, Jarosz JM, Martin RJ, et al.: MRI hyperintensities of the temporal lobe and external capsule in patients with CADASIL. Neurology 2001, 56:628–634.

    PubMed  Google Scholar 

  47. Weber T, Trebst C, Frye S, et al.: Analysis of the systemic and intrathecal humoral immune response in progressive multifocal leukoencephalopathy. J Infect Dis 1997, 176:250–254.

    Article  CAS  PubMed  Google Scholar 

  48. Calabrese LH, Molloy ES, Huang D, Ransohoff RM: Progressive multifocal leukoencephalopathy in rheumatic diseases: the evolving clinical and pathologic patterns of disease. Arthritis Rheum 2007, 56:2116–2128.

    Article  PubMed  Google Scholar 

  49. Molloy ES, Calabrese LH: Progressive multifocal leukoencephalopathy in patients with rheumatic diseases: are patients with systemic lupus erythematosus at particular risk? Autoimmun Rev 2008, 8:144–146.

    Article  CAS  PubMed  Google Scholar 

  50. Bartynski WS: Posterior reversible encephalopathy syndrome, part 1: fundamental imaging and clinical features. AJNR Am J Neuroradiol 2008, 29:1036–1042.

    Article  CAS  PubMed  Google Scholar 

  51. Min L, Zwerling J, Ocava LC, et al.: Reversible posterior leukoencephalopathy in connective tissue diseases. Semin Arthritis Rheum 2006, 35:388–395.

    Article  PubMed  Google Scholar 

  52. Eng JA, Frosch MP, Choi K, et al.: Clinical manifestations of cerebral amyloid angiopathy-related inflammation. Ann Neurol 2004, 55:250–256.

    Article  PubMed  Google Scholar 

  53. Lower EE, Wiess KL: Neurosarcoidosis. Clin Chest Med 2008, 29:475–492.

    Article  PubMed  Google Scholar 

  54. Pozzi M, Roccatagliata D, Sterzi R: Drug abuse and intracranial hemorrhage. Neurol Sci 2008, 29:S269–S270.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Rheumatology, University of South Florida, James A. Haley Veterans’ Hospital, 12901 Bruce B. Downs Boulevard, Tampa, FL, 33612, USA

    Joanne Valeriano-Marcet

Authors
  1. Helen Bateman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aasim Rehman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joanne Valeriano-Marcet
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joanne Valeriano-Marcet.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bateman, H., Rehman, A. & Valeriano-Marcet, J. Vasculitis-like syndromes. Curr Rheumatol Rep 11, 422–429 (2009). https://doi.org/10.1007/s11926-009-0062-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11926-009-0062-9

Keywords

Search

Navigation